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Central Retinal Artery Occlusion: Visual Outcomes from a Large Northern California Cohort
Ronak Shah1, Xuwen Zheng1, Amar P Patel2
1Renaissance School of Medicine at Stony Brook University, Stony Brook, New York.
Ophthalmology. Retina
|December 28, 2023
Summary
Visual acuity outcomes in central retinal artery occlusion (CRAO) are poor, with most patients experiencing no significant improvement. Early presentation and conservative treatments did not impact final visual acuity in this study.
Area of Science:
- Ophthalmology
- Retinal Vascular Diseases
Background:
- Nonarteritic central retinal artery occlusion (CRAO) is a serious condition affecting vision.
- Understanding factors influencing visual acuity (VA) outcomes is crucial for patient management.
Purpose of the Study:
- To evaluate visual acuity (VA) outcomes in a large cohort of nonarteritic central retinal artery occlusion (CRAO) patients.
- To determine if symptom onset to presentation time, initial VA, or conservative treatments affect final VA.
Main Methods:
- Retrospective cohort study of 794 patients diagnosed with CRAO between 2011 and 2020.
- Included 484 patients with comprehensive data on presentation, management, and follow-up (≥90 days).
- Excluded arteritic CRAO cases; confirmed diagnosis via chart review by two retina specialists.
Main Results:
- Most patients (89.7%) presented with severe vision impairment (VA ≤ 20/200).
- No significant difference in final VA was observed based on presentation time (≤4.5 hours vs. later).
- Conservative treatments (e.g., paracentesis, ocular massage, IOP-lowering drugs) did not significantly improve VA outcomes.
Conclusions:
- This study confirms the generally poor visual prognosis for patients with CRAO.
- Neither early presentation nor standard conservative treatments appear to improve final visual acuity.
- There is a critical need for developing effective, evidence-based treatments for CRAO.
