‘A cardiovascular problem disguised as an eye problem’: Why CRAO requires immediate treatment
Central retinal artery occlusion (CRAO), a rare form of acute ischemic stroke that affects the eye, is a medical emergency that requires immediate treatment, according to a new scientific statement from the American Heart Association.
The statement, published in full in Stroke, was developed by a team of specialists representing the fields of cardiology, neurology, ophthalmology, interventional neuroradiology, neurosurgery and vitreoretinal surgery. While these strokes are often related to problems with a patient’s carotid arteries, a CRAO may also be due to cardiovascular conditions such as atrial fibrillation.
“CRAO is a cardiovascular problem disguised as an eye problem,” Brian Mac Grory, MBBCh, BAO, chair of the statement’s writing committee and a staff neurologist at the Duke Comprehensive Stroke Center at Duke University School of Medicine, said in a prepared statement. “It is less common than stroke affecting the brain but is a critical sign of ill health and requires immediate medical attention. Unfortunately, a CRAO is a warning sign of other vascular issues, so ongoing follow-up is critical to prevent a future stroke or heart attack.”
An individual’s risk of having a CRAO increases with age, according to the scientific statement. The presence of certain cardiovascular risk factors—hypertension, Type 2 diabetes or obesity, for example—also raises that risk.
An intravenous tissue plasminogen activator is the treatment currently recommended for a CRAO. Other techniques are emerging, but additional research is still needed before the writing committee can recommend them.
“We know acute CRAO is a medical emergency requiring early recognition and triage to emergency medical treatment,” Mac Grory added. “There is a narrow time window for effective treatment of CRAO and a high rate of serious related illness. So, if a person is diagnosed in a doctor’s office or other outpatient clinic, they should be immediately sent to a hospital emergency department for further evaluation and treatment.”
The full scientific statement is available here.