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Central retinal artery occlusion as a neuro-ophthalmological emergency: the need to raise public awareness

Carolin Hoyer1, Christian Kahlert2, Resul Güney3

  • 1Department of Neurology, Medical Faculty Mannheim, University Medical Centre Mannheim, Heidelberg University, Mannheim, Germany.

European Journal of Neurology
|January 16, 2021
PubMed

Insights

Central retinal artery occlusion (CRAO) is a medical emergency. Improving patient awareness and prehospital care can enhance timely treatment and outcomes for CRAO, a critical neuro-ophthalmological condition.

Area of Science:

  • Neuroscience
  • Ophthalmology
  • Stroke Medicine

Background:

  • Central retinal artery occlusion (CRAO) is a critical neuro-ophthalmological emergency.
  • Current optimal management and treatment strategies for CRAO remain under debate.
  • This study sought to identify areas for improvement in CRAO care.

Purpose of the Study:

  • To evaluate the effectiveness of an in-hospital management guideline for CRAO.
  • To identify factors contributing to delays in CRAO treatment.
  • To assess the incidence of concurrent acute ischemic stroke lesions in CRAO patients.

Main Methods:

  • Retrospective analysis of 101 CRAO patient records from January 2016 to August 2020.
  • Evaluation of patient admission rates to a stroke unit.
  • Assessment of thrombolysis rates and reasons for non-administration.
  • Review of MRI findings for concurrent ischemic stroke lesions.

Main Results:

  • Admissions to the stroke unit increased significantly post-guideline implementation (52.2% to 97.4%).
  • Thrombolysis rates rose to 14.1%, with prehospital delays being the primary barrier (58.8%).
  • Consulting a private ophthalmologist first was a common delay factor (44.4%); 32.5% of patients had concurrent brain ischemic lesions on MRI.

Conclusions:

  • Increased public awareness of sudden vision loss as a stroke symptom is crucial.
  • Timely recognition and hospital presentation are essential for effective CRAO management.
  • Further prospective trials are needed to optimize CRAO treatment protocols.
Abstract

Keywords:
central retinal artery occlusionstroke unitthrombolysis

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