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Review
. 2022 Aug 10;14(8):e27840.
doi: 10.7759/cureus.27840. eCollection 2022 Aug.

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

Maleesha Jayasinghe  1 , Omesh Prathiraja  2 , Abdul Mueez Alam Kayani  3 , Rahul Jena  4 , Malay Singhal  5 , Minollie Suzanne Silva  6
Affiliations
Review

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

Maleesha Jayasinghe et al. Cureus. .

Abstract

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.

Keywords: central retinal artery occlusion; crao; ischemia; ocular emergency; ophthalmological emergency; retina; retinal vessels; stroke; thrombolysis; treatment.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. The general management of CRAO
CRAO: central retinal artery occlusion; FiO2: fraction of inspired oxygen; GCA: giant cell arteritis; ESR: erythrocyte sedimentation rate; INR: international normalized ratio; ECG: electrocardiogram; MRI: magnetic resonance imaging Image credit: author Maleesha Jayasinghe
Figure 2
Figure 2. Selection process
Figure 3
Figure 3. Pharmacological and non-pharmacological therapies for CRAO
CRAO: central retinal artery occlusion Image credit: author Maleesha Jayasinghe
See this image and copyright information in PMC

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