Central Retinal Artery Occlusion: Visual Outcome

Hayreh, Sohan Singh; Zimmerman, M. Bridget

doi:10.1016/j.ajo.2005.03.038

Cited by 416 publications

(432 citation statements)

References 43 publications

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“…Of these, 60% had an initial VA of 6/30 or worse. 3 Such poor results are due to the variability in size of the cilioretinal artery and the area it supplies. Therefore, CRAO infarcts will deprive retinal blood supply, reducing the thickness of the inner retinal layers.…”

Section: Anatomy and Pathophysiologymentioning

confidence: 99%

“…21,22 (2) Non-arteritic transient CRAO Non-arteritic transient CRAO (transient monocular blindness) accounts for 15-17% of CRAOs and has the best visual prognosis. 3,23 This is analogous to a TIA affecting the eye. The restoration of blood flow to the CRA then results in symptom resolution.…”

Section: Anatomy and Pathophysiologymentioning

confidence: 99%

“…However, a cilioretinal artery, if present, will maintain the thickness of the retina to variable extents, depending on how much of the retina it supplies. 3 The exact location where CRAO occurs is debated. Anatomical studies show that the narrowest part of the CRA lumen is where it pierces the dural sheath of the optic nerve and not the lamina cribrosa, and that this was the most common location where CRAO occured 11 ( Figure 1).…”

Section: Anatomy and Pathophysiologymentioning

confidence: 99%

“…16 This suggests that the time window for intervention is finite and inversely proportional to the degree of recovery. The exact retinal tolerance time when irreversible damage occurs is not yet known, but would appear to be no longer than 4 h. 16 Types of CRAO CRAO can be divided into four different subclasses: 3 (1) Non-arteritic permanent CRAO ( (1) Non-arteritic permanent CRAO…”

Section: Anatomy and Pathophysiologymentioning

confidence: 99%

“…2 A prospective study of 260 eyes with CRAO showed that people suffer profound monocular visual loss, with 80% of patients having a visual acuity (VA) of 20/400 or worse. 3 This reduction in vision increases the fall risk and thus results in increased dependency, and in worst-case scenarios leads to institutional care. 4 CRAO signifies end-organ ischaemia and often the underlying atherosclerotic disease.…”

Section: Introductionmentioning

confidence: 99%

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A review of central retinal artery occlusion: clinical presentation and management

Varma

Cugati

Lee

et al. 2013

Eye

325

298

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Central retinal artery occlusion (CRAO) is an ophthalmic emergency and the ocular analogue of cerebral stroke. Best evidence reflects that over three-quarters of patients suffer profound acute visual loss with a visual acuity of 20/400 or worse. This results in a reduced functional capacity and quality of life. There is also an increased risk of subsequent cerebral stroke and ischaemic heart disease. There are no current guideline-endorsed therapies, although the use of tissue plasminogen activator (tPA) has been investigated in two randomized controlled trials. This review will describe the pathophysiology, epidemiology, and clinical features of CRAO, and discuss current and future treatments, including the use of tPA in further clinical trials.

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Section: Anatomy and Pathophysiologymentioning

confidence: 99%

Section: Anatomy and Pathophysiologymentioning

confidence: 99%

Section: Anatomy and Pathophysiologymentioning

confidence: 99%

Section: Anatomy and Pathophysiologymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

A review of central retinal artery occlusion: clinical presentation and management

Varma

Cugati

Lee

et al. 2013

Eye

325

298

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Incidence of Retinal Artery Occlusion and Related Mortality in Korea, 2005 to 2018

Hwang

Lee²,

Kim³

et al. 2023

JAMA Netw Open

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ImportanceIt remains unclear whether comorbidities in patients with retinal artery occlusion (RAO), a rare retinal vascular disorder, differ by subtype and whether mortality is higher.ObjectiveTo examine the nationwide incidence of clinically diagnosed, nonarteritic RAO, causes of death, and mortality rate in patients with RAO compared with that in the general population in Korea.Design, Setting, and ParticipantsThis retrospective, population-based cohort study examined National Health Insurance Service claims data from 2002 to 2018. The population of South Korea was 49 705 663, according to the 2015 census. Data were analyzed from February 9, 2021, to July 30, 2022.Main Outcomes and MeasuresThe nationwide incidence of any RAO, including central RAO (CRAO; International Statistical Classification of Diseases and Related Health Problems, Tenth Revision [ICD-10] code, H34.1) and noncentral RAO (other RAO; ICD-10 code, H34.2) was estimated using National Health Insurance Service claims data from 2002 to 2018, with 2002 to 2004 as the washout period. Furthermore, the causes of death were evaluated and the standardized mortality ratio was estimated. The primary outcomes were the incidence of RAO per 100 000 person-years and the standardized mortality ratio (SMR).ResultsA total of 51 326 patients with RAO were identified (28 857 [56.2%] men; mean [SD] age at index date: 63.6 [14.1] years). The nationwide incidence of any RAO was 7.38 (95% CI, 7.32-7.44) per 100 000 person-years. The incidence rate of noncentral RAO was 5.12 (95% CI, 5.07-5.18), more than twice that of CRAO (2.25 [95% CI, 2.22-2.29]). Mortality was higher in patients with any RAO than in the general population (SMR, 7.33 [95% CI, 7.15-7.50]). The SMR for CRAO (9.95 [95% CI, 9.61-10.29]) and for noncentral RAO (5.97 [95% CI, 5.78-6.16]) showed a tendency toward a gradual decrease with increasing age. The top 3 causes of death in patients with RAO were diseases of the circulatory system (28.8%), neoplasms (25.1%), and diseases of the respiratory system (10.2%).Conclusions and RelevanceThis cohort study found that the incidence rate of noncentral RAO was higher than that of CRAO, whereas SMR was higher for CRAO than noncentral RAO. Patients with RAO show higher mortality than the general population, with circulatory system disease as the leading cause of death. These findings suggest that it is necessary to investigate the risk of cardiovascular or cerebrovascular disease in patients newly diagnosed with RAO.

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