Purpose: To compare the effect of tissue plasminogen activator (TPA) and aspirin in patients with central retinal vein occlusion.

Methods: A prospective interventional study was conducted on patients with central retinal vein occlusion of less than 28 days' duration. Patients in the TPA group received 100 μg intravitreal tissue plasminogen activator and the patients who declined intravitreal injection were considered as Aspirin group. Patients were followed up for 6 months.

Results: sixty five patients were enrolled, 19 in the TPA group and 46 in the Aspirin group. The mean 6-month change in visual acuity for TPA-treated patients was -0.29±0.42 (range: -1.4 to +0.5) while in the Aspirin group, it was 0.28±0.79 with a range of -1 to +2.5. TPA group had a significantly better visual improvement in comparison to Aspirin group (P< 0.0005).

Conclusion: Intravitreal tissue plasminogen activator can be injected safely and easily. Patients treated with intravitreal tissue plasminogen activator within 28 days of the onset of central retinal vein occlusion are more likely to improve visual acuity.