Skip to main content

Management of Central Retinal Artery Occlusion: A Scientific Statement From the American Heart Association.

Publication ,  Journal Article
Mac Grory, B; Schrag, M; Biousse, V; Furie, KL; Gerhard-Herman, M; Lavin, PJ; Sobrin, L; Tjoumakaris, SI; Weyand, CM; Yaghi, S ...
Published in: Stroke
June 2021

PURPOSE: Central retinal artery occlusion (CRAO) is a form of acute ischemic stroke that causes severe visual loss and is a harbinger of further cerebrovascular and cardiovascular events. There is a paucity of scientific information on the appropriate management of CRAO, with most strategies based on observational literature and expert opinion. In this scientific statement, we critically appraise the literature on CRAO and provide a framework within which to consider acute treatment and secondary prevention. METHODS: We performed a literature review of randomized controlled clinical trials, prospective and retrospective cohort studies, case-control studies, case reports, clinical guidelines, review articles, basic science articles, and editorials concerning the management of CRAO. We assembled a panel comprising experts in the fields of vascular neurology, neuro-ophthalmology, vitreo-retinal surgery, immunology, endovascular neurosurgery, and cardiology, and document sections were divided among the writing group members. Each member received an assignment to perform a literature review, synthesize the data, and offer considerations for practice. Multiple drafts were circulated among the group until consensus was achieved. RESULTS: Acute CRAO is a medical emergency. Systems of care should evolve to prioritize early recognition and triage of CRAO to emergency medical attention. There is considerable variability in management patterns among practitioners, institutions, and subspecialty groups. The current literature suggests that treatment with intravenous tissue plasminogen activator may be effective. Patients should undergo urgent screening and treatment of vascular risk factors. There is a need for high-quality, randomized clinical trials in this field.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Stroke

DOI

EISSN

1524-4628

Publication Date

June 2021

Volume

52

Issue

6

Start / End Page

e282 / e294

Location

United States

Related Subject Headings

  • United States
  • Triage
  • Tissue Plasminogen Activator
  • Secondary Prevention
  • Retrospective Studies
  • Retinal Artery Occlusion
  • Retinal Artery
  • Randomized Controlled Trials as Topic
  • Prospective Studies
  • Neurosurgical Procedures
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Mac Grory, B., Schrag, M., Biousse, V., Furie, K. L., Gerhard-Herman, M., Lavin, P. J., … American Heart Association Stroke Council; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Hypertension; and Council on Peripheral Vascular Disease, . (2021). Management of Central Retinal Artery Occlusion: A Scientific Statement From the American Heart Association. Stroke, 52(6), e282–e294. https://doi.org/10.1161/STR.0000000000000366
Mac Grory, Brian, Matthew Schrag, Valérie Biousse, Karen L. Furie, Marie Gerhard-Herman, Patrick J. Lavin, Lucia Sobrin, et al. “Management of Central Retinal Artery Occlusion: A Scientific Statement From the American Heart Association.Stroke 52, no. 6 (June 2021): e282–94. https://doi.org/10.1161/STR.0000000000000366.
Mac Grory B, Schrag M, Biousse V, Furie KL, Gerhard-Herman M, Lavin PJ, et al. Management of Central Retinal Artery Occlusion: A Scientific Statement From the American Heart Association. Stroke. 2021 Jun;52(6):e282–94.
Mac Grory, Brian, et al. “Management of Central Retinal Artery Occlusion: A Scientific Statement From the American Heart Association.Stroke, vol. 52, no. 6, June 2021, pp. e282–94. Pubmed, doi:10.1161/STR.0000000000000366.
Mac Grory B, Schrag M, Biousse V, Furie KL, Gerhard-Herman M, Lavin PJ, Sobrin L, Tjoumakaris SI, Weyand CM, Yaghi S, American Heart Association Stroke Council; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Hypertension; and Council on Peripheral Vascular Disease. Management of Central Retinal Artery Occlusion: A Scientific Statement From the American Heart Association. Stroke. 2021 Jun;52(6):e282–e294.

Published In

Stroke

DOI

EISSN

1524-4628

Publication Date

June 2021

Volume

52

Issue

6

Start / End Page

e282 / e294

Location

United States

Related Subject Headings

  • United States
  • Triage
  • Tissue Plasminogen Activator
  • Secondary Prevention
  • Retrospective Studies
  • Retinal Artery Occlusion
  • Retinal Artery
  • Randomized Controlled Trials as Topic
  • Prospective Studies
  • Neurosurgical Procedures