A Phase III Randomized, Blind, Double Dummy, Multicenter Study Assessing the Efficacy and Safety of IV THrombolysis (Alteplase) in Patients With acutE Central retInal Artery Occlusion

Inclusion Criteria: * Patients aged up to 18 years * CRAO diagnosis by fundoscopic examination or non-mydriatic retinophotography (NMR) performed by an ophthalmologist. * Blindness defined according to WHO classification as visual acuity \<1/20 (20/400). * Treatment intervention should be initiated by a stroke team as quickly as possible and within 4.5 hours from symptom onset. * No clinical (e.g headache with jaw claudication or scalp tenderness, no temporal pulse) or laboratory evidence (elevated CRP) of giant cell arteritis * No clinical or radiological evidence of stroke within the last 3 months. * Patients covered by health care insurance (social security) * Written informed consent obtained. Exclusion Criteria: * Symptoms onset more than 4.5 h prior to infusion start or undetermined time of symptom onset. * Minor VA deficit or VA rapidly improving before start of infusion. * CRAO without foveal ischemia. * Other retinal vascular disease: occlusion of branch of the CRA without significant VA loss, occlusion of the retinal vein, proliferative diabetic retinopathy or any other severe retinopathy. * Clinical or laboratory evidence of temporal arteritis. * Evidence of ICH or ischemic stroke on the pre-administration CT scan or MRI. * Pregnant or lactating women * Minors * Adults under guardianship or trusteeship * Any contraindication to alteplase * Any contraindication to aspirin