Acute occlusion of the retinal arteries: current concepts and recent advances in diagnosis and management

Purpose/Background - Central retinal artery occlusion (CRAO) is usually a b linding event, and is not an infrequent presentation to the accident and em ergency (A&E) department. The evidence-base in support of current treatment options is weak. Methods - This paper reviewed the Literature germane to the diagnostic, the rapeutic and prognostic aspects of retinal arterial occlusive disease. Results-The visual prognosis associated with CRAO remains poor, and current therapeutic practices are of unproven benefit. The non-ophthalmologist in the A&E department should Lie the patient hat and give a stat dose of intra venous acetazolamide in an attempt to improve the retinal perfusion pressur e. Conclusion - The management of acute occlusion of the central retinal arter y has not changed over the past 30 years, although the potential benefits o f superselective intra-arterial fibrinolytic therapy warrant evaluation in a randomised controlled trial. The identification of underlying pathology i s an essential component of medical care, and all cases should be followed up by an ophthalmologist because of the possibility of ocular rubeosis.