What is the standard treatment for central retinal artery occlusion (CRAO)?

Updated: Jun 11, 2019
  • Author: Robert H Graham, MD; Chief Editor: Andrew G Lee, MD  more...
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Answer

There is no standard treatment for CRAO. [10]

Among the suggested treatments are noninvasive and more invasive treatments. Some of the noninvasive treatments include ocular massage, hyperbaric oxygen (HBO) therapy, carbogen inhalation therapy, intraocular pressure reduction (with systemic or local agents), anticoagulation therapy, sublingual isosorbide therapy, and systemic steroid therapy. The goal of each is to increase blood flow and blood oxygen content.

Invasive procedures include anterior chamber paracentesis, laser embolectomy, pars plana vitrectomy, and intraarterial thrombolysis. Most invasive procedures are aimed to reduce intraocular pressure and lyse/dislodge the obstructive embolus, although none of the treatments has enough supportive evidence to become the standard of care. Recent publications demonstrated that intraarterial thrombolysis may be an alternative to recover blood flow and vision after embolic CRAO. [31]


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