The Asia-Pacific Journal of Ophthalmology

Asia-Pacific Journal of Ophthalmology:

Issue 4, July/August 2018 Review Article

Treatment of Nonarteritic Acute Central Retinal Artery Occlusion

Sharma, Rahul A.; Dattilo, Michael; Newman, Nancy J.; Biousse, Valerie



Author Information 


From the *Department of Ophthalmology, The University of Ottawa, Ottawa, ON, Canada; and Departments of †Ophthalmology, ‡Neurology, and §Neurological Surgery, Emory University School of Medicine, Atlanta, GA.


Reprints: Valerie Biousse, Emory Eye Center, 1365B Clifton Rd, Atlanta, GA 30322. E-mail: vbiouss@emory.edu.


Abstract 


Central retinal artery occlusion (CRAO) is an event most often caused by an embolus originating in the ipsilateral carotid artery, aortic arch, or heart. CRAO may result from partial or complete occlusion of the central retinal artery (CRA), which acts as the primary blood supply to the inner neurosensory retina, and typically results in profound
vision loss and permanent visual disability. No consensus has emerged regarding the optimal treatment of CRAO. All proposed treatments are of questionable efficacy and many have uncertain risk profiles. In certain circumstances, thrombolysis may be attempted as a treatment option; however, the evidence to support broad use of thrombolytics in the treatment of acute CRAO remains elusive. It is known that the risk factors that predispose to other cardiovascular and cerebrovascular events are often present in CRAO. Accordingly, identification of patients at highest risk of stroke and secondary prevention of ischemic events remains the primary focus of management. This review offers a summary of the clinical presentation, diagnosis, and prognosis of CRAO, with an emphasis on treatment options.




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