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Year : 2021  |  Volume : 11  |  Issue : 1  |  Page : 16-24

Conservative treatments for acute nonarteritic central retinal artery occlusion: Do they work?

1 Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, USA
2 Department of Ophthalmology; Department of Neurology; Department of Neurological Surgery, Emory University School of Medicine, Atlanta, Georgia, USA
3 Department of Ophthalmology; Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA

Correspondence Address:
Dr. Rahul A Sharma
Neuro-Ophthalmology Unit, Emory Eye Center, The Emory Clinic, 1365-B Clifton Road NE, Atlanta, Georgia 30322
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/tjo.tjo_61_20

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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.

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