Central Retinal Artery Occlusion: Acute Management and Treatment

Abstract

Purpose of Review This review will seek to answer if advances in ophthalmic imaging and evolution of treatment modalities have shed further light on the epidemiology, pathophysiology, diagnosis, and acute management of acute CRAO. Recent Findings Imaging characteristics of acute CRAO have been further characterized with the use of fluorescein angiography, optical coherence tomography (OCT), OCT-angiography, and indocyanine-green angiography. Layer segmentation of OCT imaging has found inner retinal layer hyper-reflectivity to be a common finding in acute CRAO. Non-invasive therapies, fibrinolytic delivery, and surgical interventions for acute CRAO have been further evaluated as potential management tools. Summary A large body of literature reports very inconsistent treatment success with a wide variety of modalities. Currently, there is no clear evidence supporting the use of fibrinolytics in acute CRAO. Large, multicenter, randomized control trials are necessary to elucidate the role of the various acute treatment options in the management of CRAO.

Central retinal artery occlusion combined with posterior ciliary artery occlusion after preoperative embolization of the middle meningeal artery for intracranial meningioma

“…The central retinal artery provides circulation to the inner retina, whereas the posterior ciliary artery supplies the outer retina, choroid, and optic nerve head. [ 13 , 14 ] In the present case early fluorescence angiography depicted an absence of choroidal fluorescence, and in the late phase there were triangular hyperfluorescent patches, confirming choroidal ischemia. Due to poor blood supply to the choroid, optic nerve head, and retina, fundus examination after 2 months revealed optic disc atrophy and thinning of the whole retina and choroid.…”

Fenofibrate Protects against Retinal Dysfunction in a Murine Model of Common Carotid Artery Occlusion-Induced Ocular Ischemia

“…The incidence of CRAO is around 1.9 in 100,000 and its incidence increases with aging [ 3 , 4 ]. The major causes of this disease are divided into two categories: non-arthritis and arteritis [ 5 , 6 ]. More than 90% of causes are non-arthritis such as carotid artery atherosclerosis, cardiogenic embolism, hematological conditions and other vascular diseases [ 7 , 8 ].…”

ANCA-Negative Churg-Strauss Syndrome Presenting as Bilateral Central Retinal Artery Occlusion: A Case Report

“…The arteritic category comprises less than 5% of CRAO cases and is related to a vasculitic etiology. 2 Eosinophilic granulomatosis with polyangiitis (EGPA), also called Churg-Strauss syndrome (CSS), is known as a form of vasculitis characterized by inflammation of the blood vessels that can restrict blood flow and damage vital organs and tissues. Individuals diagnosed with EGPA usually have a history of asthma or allergies.…”