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Central Retinal Artery Occlusion: Acute Management and Treatment

Current Ophthalmology Reports volume 5, pages 149–159 (2017)Cite this article

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 central retinal artery occlusion (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.

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Acknowledgements

Special thanks for Jay Sridhar for reviewing this paper.

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Affiliations

  1. Department of Ophthalmology, New York University, New York, NY, USA

    Nitish Mehta & Yasha Modi

  2. Vitreous Retina Macula Consultants of New York, New York, NY, USA

    Rosa Dolz Marco

  3. Bascom Palmer Eye Institute, Miami, FL, USA

    Raquel Goldhardt

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  1. Nitish Mehta
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  2. Rosa Dolz Marco
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Correspondence to Raquel Goldhardt.

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Yasha Modi is Advisory Board Member at Genentech, Inc.

Rosa Dolz-Marco, Nitish Mehta, and Raquel Goldhardt declare no conflicts of interest.

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This article is part of the Topical Collection on Therapies in Age-Related Macular Degeneration

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Mehta, N., Marco, R.D., Goldhardt, R. et al. Central Retinal Artery Occlusion: Acute Management and Treatment. Curr Ophthalmol Rep 5, 149–159 (2017). https://doi.org/10.1007/s40135-017-0135-2

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Keywords

  • Retina
  • Central retinal artery occlusion
  • Intra-arterial tPA
  • Optical coherence tomography angiography