Abstract
Purpose :
While central retinal artery occlusion (CRAO) is relatively rare, it is associated with vision loss in over 75% of cases. Despite these severe outcomes, there continues to be significant controversy over best treatment practices. Our objective is to summarize global preferred practice patterns for the management of central retinal artery occlusions.
Methods :
An online survey was distributed to trauma centers throughout the world to assess institutional management practice patterns for central artery occlusions.
Results :
Responses were collected from 33 institutions (response rate 33/42, 78.6%) distributed across Asia (39.4%), North America (33.3%), South America (12.1%), Africa (9.1%), and Europe (6.1%). Approaches to manage CRAO diverged amongst respondents. The majority of respondents performed an anterior chamber (AC) paracentesis (n=31, 93.9%) after the diagnosis was made. The reported permissible time range from onset of CRAO to performing AC paracentesis varied, with 11 centers (33.3%) performing the procedure within 6 hours of onset, 2 centers (6.1%) within 12 hours, and 2 centers (6.1%) within 24 hours. Hyperventilation and/or an ocular massage were each performed at 57.6% of centers (n=19). 39.4% of respondents administered a beta blocker (timolol, n=13). Two centers reported administering tissue plasminogen activator (tPA, n=2, 6.1%); one through an intra-arterial approach and the other through an intravenous route. Only one center (3.0%) routinely uses non-invasive oxygenation for CRAO patients.
Conclusions :
Conventional treatment paradigms for central retinal artery occlusions differ considerably. Evidence-based guidelines for the management of CRAO are needed to resolve controversies in care.
This is a 2021 ARVO Annual Meeting abstract.