Central retinal artery occlusion (CRAO) is a significant cause of blindness and is associated with a considerable risk of heart attacks, strokes and death. Our major research objective in confronting this terrible disease is to 1) identify the best treatment(s) to rescue the visual function of the retina and 2) to identify the risk factors which are common to both CRAO and cerebrovascular/cardiovascular risk. As part of this process, we felt it was essential to understand how acute CRAO is treated at academic hospitals in the United States. We discovered that there is a high-degree of variability in how both the treatments employed and the risk factor screening that is done after an acute CRAO. This work has been accepted for publication in the Journal of Neurology and the pre-print version is available under the “Lab Projects” tab.
We found that risk factor screening was most-thorough when acute CRAO management involved both ophthalmologists and neurologists in collaboration. We also found that a little over half of programs were willing to treat appropriate patients with acute CRAO with tissue plasminogen activator (tPA). As we consider whether or not a clinical trial of intravenous tPA for acute CRAO is justified, this finding importantly establishes that there is equipoise regarding the potential efficacy of fibrinolysis for acute CRAO. Finally, we believe the that high-degree of variability found in this survey should ideally prompt the formulation of multidisciplinary guidelines to guide the treatment and risk factor screening of patients with acute CRAO.