Central Retinal Artery Occlusion: Can We Effectively Manage This Ocular Emergency in a Hospital Setting?

Central retinal artery occlusion (CRAO) is an ophthalmological emergency characterized by partial or complete occlusion of the central retinal artery. It is the ocular equivalent of an ischemic cerebral stroke. Patients frequently present with a significant, abrupt, painless loss of vision in one ey...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2022-08, Vol.14 (8), p.e27840-e27840
Main Authors: Jayasinghe, Maleesha, Prathiraja, Omesh, Kayani, Abdul Mueez Alam, Jena, Rahul, Singhal, Malay, Silva, Minollie Suzanne
Format: Article
Language:English
Subjects:
Clinical trials
Emergency Medicine
Internal Medicine
Ischemia
Magnetic resonance imaging
Ophthalmology
Oxygen therapy
Pathophysiology
Patients
Risk factors
Stroke
Thromboembolism
Veins & arteries
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Summary:Central retinal artery occlusion (CRAO) is an ophthalmological emergency characterized by partial or complete occlusion of the central retinal artery. It is the ocular equivalent of an ischemic cerebral stroke. Patients frequently present with a significant, abrupt, painless loss of vision in one eye, with only around 20% of those affected getting functional visual acuity restored in the affected eye. Despite more than 150 years of clinical research, no consensus has been achieved regarding the most effective method of treating CRAO. The efficacy of all proposed treatments is debatable, and many of them have ambiguous risk profiles that present particular diagnostic and management difficulties and cause variations in clinical practice. In certain circumstances, thrombolysis may be attempted as a treatment option. However, the evidence to support the general use of thrombolytics in treating acute CRAO remains elusive. It is known that the risk factors predisposing to other cardiovascular and cerebrovascular events are often present in CRAO. Accordingly, identifying patients at the highest risk of stroke and secondary prevention of ischemic events remains the primary focus of management. This review offers a summary of all the current treatment options available for managing CRAO, with particular reference to their limitations and inconsistent results found in relevant studies until 2022.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.27840