Interventions for acute non-arteritic central retinal artery occlusion

Area of Science:

• Ophthalmology
• Retinal Vascular Diseases
• Clinical Trials

Background:

• Acute non-arteritic central retinal artery occlusion (CRAO) causes sudden, severe vision loss.
• Existing therapeutic interventions for CRAO lack a universally agreed-upon treatment regimen.

Purpose of the Study:

• To systematically assess the efficacy of various treatments for acute non-arteritic CRAO.
• To evaluate the impact of interventions on visual acuity, quality of life, and adverse events.

Main Methods:

• Conducted a comprehensive search of multiple electronic databases for randomized controlled trials (RCTs).
• Included six RCTs involving 223 participants with acute non-arteritic CRAO.
• Assessed outcomes using the GRADE classification for certainty of evidence.

Main Results:

• No significant difference in visual acuity was found between tissue plasminogen activator (t-PA) and saline, or between t-PA and other interventions.
• Transcorneal electrical stimulation (TES) showed no difference in visual acuity across different stimulation levels.
• Participants receiving t-PA experienced a higher rate of serious adverse effects; other comparisons reported no statistically significant differences or lacked data on secondary outcomes.

Conclusions:

• Current evidence suggests proposed interventions for acute non-arteritic CRAO may not be superior to observation or basic supportive treatments.
• The certainty of evidence is low, highlighting significant heterogeneity among the included studies.
• Large, well-designed RCTs are essential to establish effective treatments for acute non-arteritic CRAO.