What is the natural history of CRAO visual acuity?

Without treatment: 74% of CRAO eyes have final VA of counting fingers or worse. Only 10-15% achieve VA >=20/400. Cilioretinal artery-sparing CRAO has better prognosis (33% achieve >=20/40). Prognosis is better if initial VA is better.

Is IV tPA effective for CRAO?

EAGLE trial (2020): IV tPA within 4.5h of CRAO onset showed no significant benefit over conservative management (17% vs 15% visual recovery). However, EAGLE enrolled late; case series suggest benefit within 4-6h of true onset.

What should be done immediately for suspected CRAO?

Immediate management: ocular massage, paracentesis, inhalation of carbogen (5% CO2 in O2), and emergency evaluation for carotid artery disease and cardioembolic sources. Stroke workup is mandatory as CRAO is equivalent to retinal stroke.

Central Retinal Artery Occlusion VA Prognosis

Estimate visual acuity prognosis after central retinal artery occlusion (CRAO). Without treatment, final VA is typically counting fingers or worse in 66%; within 4-6h window, IV tPA may improve outcomes.

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Central Retinal Artery Occlusion VA Prognosis

Frequently Asked Questions

What is the natural history of CRAO visual acuity?

Is IV tPA effective for CRAO?

What should be done immediately for suspected CRAO?