| Abstract [eng] |
The central retinal artery occlusion, or so-called ischemic ocular stroke, is a challenging diagnosis for patients and physicians. The bad outcome that it currently brings along is linked to issues that remind one of the pathways that cerebral ischemic stroke management had to go through over the last decades. Likewise, as with the cerebral ischemic stroke, a neurological approach to central retinal artery occlusion patients is only possible in stroke units, where ophthalmologists are usually not available. Therefore, the diagnostic workup is already challenging. However, even if diagnosed within the debated timeframe, treatment is still without evidence and not to be found in approved stroke guidelines from the American and European stroke associations. Intravenous and intraarterial thrombolysis, according to today’s research, are walking a fine line between improved vision and adverse effects. This literature review summarizes the current findings on central retinal artery occlusion management while focusing on the neurologic diagnostic and therapeutic process. It shows the potential for neurologic point-of-care ultrasound in combination with optical coherence tomography and diffusion-weighted magnetic resonance imaging for the improvement of the diagnostic process. Research on therapeutic intravenous thrombolysis on central retinal artery occlusion patients shows promising results. At the same time, conservative methods such as ocular massage, hyperbaric oxygen therapy, and others remain without evidence of effectiveness. Furthermore, not only because of increased rates of ischemic cerebral stroke and neovascular glaucoma in patients with central retinal artery occlusion, the awareness of the disease, both among medical and non-medical societies, must be raised. An effective interplay among medical specialists remains key for the optimal central retinal artery occlusion management. |
