Open AccessConservative treatments for acute nonarteritic central retinal artery occlusion: Do they work?
Author(s) -
Rahul Sharma,
Nancy J. Newman,
Valérie Biousse
Publication year - 2021
Publication title -
taiwan journal of ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.519
H-Index - 9
eISSN - 2211-5072
pISSN - 2211-5056
DOI - 10.4103/tjo.tjo_61_20
Subject(s) - medicine , central retinal artery occlusion , embolectomy , pentoxifylline , paracentesis , stroke (engine) , anesthesia , intensive care medicine , surgery , visual acuity , ascites , pulmonary embolism , mechanical engineering , engineering
Acute central retinal arterial occlusion has a very poor visual prognosis. Unfortunately, there is a dearth of evidence to support the use of any of the so-called "conservative" treatment options for CRAO, and the use of thrombolytics remains controversial. In this review, we address a variety of these "conservative" pharmacologic treatments (pentoxifylline, isosorbide dinitrate, and acetazolamide) and nonpharmacologic approaches (carbogen, hyperbaric oxygen, ocular massage, anterior chamber paracentesis, laser embolectomy, and hemodilution) that have been proposed as potential treatments of this condition. We conclude that the available evidence for all treatments is insufficient to conclude that any treatment will influence the natural history of this disorder. Management of CRAO patients should instead focus on reducing the risk of subsequent ischemic events, including cerebral stroke. Certain patients may be considered for acute treatment with thrombolytics, although further research must clarify the efficacy, safety, and optimal use of these therapies.