Central retinal artery occlusion (CRAO) - case report

Jędrzej Tkaczyk, Klaudia Brożyna, Katarzyna Baltaziak, Krystian Ciechański, Dominika Nowakowska, Robert Rejdak

Abstract


Central retinal artery occlusion (CRAO) is an ophthalmic emergency, most commonly caused by an embolism, usually from the carotid arteries. It can be considered as an acute stroke of the eye, and is an ocular analogue of cerebral stroke. The incidence of CRAO is estimated to be 1 in 100 000 people. Risk factors include hypertension, carotid atherosclerosis, structural cardiac pathology, coronary heart disease, cerebral vascular accident, and diabetes mellitus. CRAO usually presents with a sudden, painless loss of vision.
52 - year old male was admitted to the Ophthalmology ER, reporting a painless monocular vision loss in a right eye for two days. After such a long time from the occurrence of symptoms, there weren’t any possible treatment methods for this patient, besides preventing future embolic events. Ophthalmological examination showed only a light perception in a right eye and vision in the left eye was 1.0. Patient was diagnosed to identify risk factors of CRAO: hypertension, hypercholesterolemia, atherosclerosis or thrombophilia. He was qualified for a careful observation for the atherosclerotic risk factors and educated, that in case of occurrence of the similar symptoms, he needs to report to a Ophthalmologist immediately.
Currently, there are two main types of treating an acute non-arteritic CRAO: the first: ‘standard’, non-invasive method, and the second: using the thrombolytics deployed intravenously or intra-arterially. Unfortunately, they couldn’t be used to treat described patient, since he has already been in a late phase of CRAO.

Keywords


CRAO; occlusion; ophthalmology

Full Text:

PDF

References


von Graefes A. Ueber Embolie der Arteria centralis retinae als Ursache plötzlicher Erblindung. Arch Ophthalmol. 1859;5:136–157.

Babikian V, Wijman C, A, C, Koleini B, Malik S, N, Goyal N, Matjucha I, C, A, Retinal Ischemia and Embolism . Cerebrovasc Dis 2001;12:108-113

Arruga J, Sanders MD. Ophthalmologic findings in 70 patients with evidence of retinal embolism. Ophthalmology 1982; 89:1336–1347

Varma DD, Cugati S, Lee AW, Chen CS. A review of central retinal artery occlusion: clinical presentation and management. Eye. 2013;27(6):688-697.

Rumelt S, Dorenboim Y, Rehany U. Aggressive systematic treatment for central retinal artery occlusion. Am J Ophthalmol. 1999;128:733–738.

San-Ni Chen; Chen-Cheng Chao; Jiunn-Feng Hwang; Chung-May Yang. Clinical manifestations of central retinal artery occlusion in eyes of proliferative diabetic retinopathy with previous vitrectomy and panretinal photocoagulation. Retina (Philadelphia, Pa.). 2014; 34(9):1861–1866,

Justice J, Lehmann RP. Cilioretinal arteries: a study based on review of stereo fundus photographs and fluorescein angiographic findings. Arch Ophthalmol. 1976;94:1355.

Savino PJ, Glaser JS, Cassady J. Retinal stroke: is the patient at risk. Arch Ophthalmol. 1977;95:1185.

Hayreh SS, Zimmerman MB. Fundus changes in central retinal artery occlusion. Retina. 2007;27:276–289.

Cugati S, Varma DD, Chen CS, Lee AW. Treatment Options for Central Retinal Artery Occlusion. Current Treatment Options in Neurology. 2013;15(1):63-77. doi:10.1007/s11940-012-0202-9.

Hayreh SS, Zimmerman MB, Kimura A, Sanon A. Central retinal artery occlusion: retinal survival time. Exp Eye Res. 2004;78:723–736. doi: 10.1016/S0014-4835(03)00214-8.

Hayreh SS, Zimmerman MB. Central retinal artery occlusion: visual outcome. Am J Ophthalmol. 2005;140 (3:376–391.

Atebara NH, Brown GC, Cater J. Efficacy of anterior chamber paracentesis and Carbogen in treating acute nonarteritic central retinal artery occlusion Ophthalmology 19951022029–2034.discussion 2034–5.

Biousse V, Calvetti O, Bruce BB, Newman NJ. Thrombolysis for central retinal artery occlusion. J Neuro-Ophthalmol. 2007;27:215–230.

Fraser SG, Adams W. Interventions for acute non-arteritic central retinal artery occlusion. Cochrane Database Syst Rev. 2009;1:CD001989.

Schumacher M, Schmidt D, Jurklies B, Gall C, Wanke I, Schmoor C, et al. Central retinal artery occlusion: local intra-arterial fibrinolysis versus conservative treatment, a multicenter randomized trial Ophthalmology 20101171367–1375.e1361.

Mueller AJ, Neubauer AS, Schaller U, Kampik A. Evaluation of minimally invasive therapies and rationale for a prospective randomized trial to evaluate selective intra-arterial lysis for clinically complete central retinal artery occlusion. Arch Ophthalmol. 2003;121:1377–1381.

Schumacher M, Schmidt D, Wakhloo A. Intra-arterial fibrinolytic therapy in central retinal artery occlusion. Neuroradiology. 1993;35:600–605.

Schmidt DP, Schulte-Mönting J, Schumacher M. Prognosis of central retinal artery occlusion: local intraarterial fibrinolysis versus conservative treatment. Am J Neuroradiol. 2002;23:1301–1307.

Hacke W, Kaste M, Fieschi C, Toni D, Lesaffre E, von Kummer R, et al. Intravenous thrombolysis with recombinant tissue plasminogen activator for acute hemispheric stroke. JAMA. 1995;274:1017–1025.

Arnold M, Koerner U, Remonda L, Nedeltchev K, Mattle HP, Schroth G, et al. Comparison of intra-arterial thrombolysis with conventional treatment in patients with acute central retinal artery occlusion. J Neurol Neurosurg Psychiatry. 2005;76:196–199.




DOI: http://dx.doi.org/10.5281/m9.figshare.6990896

Refbacks

  • There are currently no refbacks.




Copyright (c) 2018 © The Author(s)

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Journal of Education, Health and Sport formerly Journal of Health Sciences

Declaration on the original version.

Editors indicates that the main version of the magazine is to issue a "electronic".

The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019.

1223 Journal of Education, Health and Sport eISSN 2391-8306 7

ISSN 2391-8306 formerly ISSN: 1429-9623 / 2300-665X

Archives 2011 - 2014

PBN 2011 - 2014

https://pbn.nauka.gov.pl/sedno-webapp/search?search&searchCategory=WORK&filter.inJournal=36616

POL-index 2011 - 2014

https://pbn.nauka.gov.pl/polindex-webapp/browse/journal/journal-32a319c5-a850-4f44-ba70-1418a6087655

BASE 2011 - 2014

https://www.base-search.net/Search/Results?lookfor=Journal+of+Health+Sciences+%28Radom%29&type=all&oaboost=1&ling=1&name=&thes=&refid=dcrespl&newsearch=1

http://elibrary.ru/contents.asp?titleid=37467

http://journal.rsw.edu.pl/index.php/JHS/issue/archive

Indexed in Bases, Bazy indeksacyjne: ERIH Plus, Worldcat, PBN/POL-Index, ICI Journals Master List, Directory of Open Access Journals (DOAJ), ZBD, Ulrich's periodicals, Google Scholar, Polska Bibliografia Lekarska

US NLM = 101679844

101679844 - NLM Catalog Result - NCBI

https://www.ncbi.nlm.nih.gov/nlmcatalog/101679844

Find a library that holds this journal: http://worldcat.org/issn/23918306

Journal Language(s): English 

PBN Poland

https://pbn.nauka.gov.pl/sedno-webapp/journals/49068

POL-index

https://pbn.nauka.gov.pl/polindex-webapp/browse/journal/journal-c39c8169-88d2-45db-9e7f-d948ce9981c4

BASE

https://www.base-search.net/Search/Results?join=AND&bool0[]=AND&lookfor0[]=2391-8306&type0[]=all&page=11&l=pl&oaboost=1&refid=dcpagepl

Redaction, Publisher and Editorial Office

Instytut Kultury Fizycznej Uniwersytet Kazimierza Wielkiego w Bydgoszczy, Institute of Physical Education Kazimierz Wielki University in Bydgoszcz, Poland 85-091 Bydgoszcz ul. Sportowa 2  www.ukw.edu.pl Copyright by Instytut Kultury Fizycznej UKW w Bydgoszczy http://ojs.ukw.edu.pl/index.php/johs  Open Access ISSN 2391-8306 formerly ISSN: 1429-9623 / 2300-665X

The journal has been approved for inclusion in ERIH PLUS.

The ERIH PLUS listing of the journal is available at https://dbh.nsd.uib.no/publiseringskanaler/erihplus/periodical/info?id=485984

SIC Science citation index (calculated on the basis of TCI and Page Rank) 0

Russian Impact factor 0.16

Indexed in Index Copernicus Journals Master List.

http://journals.indexcopernicus.com/Journal+of+Education+Health+and+Sport,p24782242,3.html

ICV 2018 = 95.95 ICV 2017 = 91.30 ICV 2016 = 84.69 ICV 2015 = 93.34 ICV 2014 = 89.51 Standardized Value: 8.27 ICV 2013: 7.32 ICV 2012: 6.41 ICV 20115.48

The InfoBase Index IBI Factor for the year 2015 is 3.56 in InfoBase Index.com.

Website: www.infobaseindex.com

Universal Impact Factor 1.78 for year 2012. (http://www.uifactor.org/AppliedJournals.aspx)

Indexed in Polish Scholarly Bibliography (PBN) (PBN Polska Bibliografia Naukowa) (https://pbn.nauka.gov.pl/journals/36616)

is a portal of the Polish Ministry of Science and Higher Education, collecting information on publications of Polish scientists and on Polish and foreign scholarly journals. Polish Scholarly Bibliograhpy is a part of POL-on - System of Information on Higher Education. It is operated by the Interdisciplinary Centre for Mathematical and Computational Modelling, University of Warsaw.

Indexed in Russian Sciences Index Российский индекс научного цитирования (РИНЦ) http://elibrary.ru/contents.asp?titleid=37467

Indexed in Arianta Polish scientific and professional electronic journals Aneta Drabek i Arkadiusz Pulikowski

(http://www1.bg.us.edu.pl/bazy/czasopisma/czasop_full.asp?id=3595)