Central Retinal Artery Occlusion

Power point of case presentation of acute central retinal artery occlusion (CRAO) treated with tPA. Risk factors for stroke and results of EAGLE study reviewed. Imaging: Number of Figures and legend for each: 12 Slide 3: Figure 1: Table 1: Exam Findings Slide 3: Figure 2: Table 2: Exam Findings Continued Slide 5: Figure 3: Fundus photo of left eye representative of central retinal artery occlusion. Shown is a cherry red macula and boxcarring. Slide 10: Figure 4: Table 3: Demonstrates visual outcome in patients with presenting visual acuity of counting fingers or worse. from Hayreh SS, Zimmerman MB. Central retinal artery occlusion: visual outcome. Am J Ophthalmol 2005; 140:376 - 391. Slide 13: Figure 5: Table 4: Compares characteristics of CRAO cohorts who had no treatment, conservative treatment, or intravenous fibrinolysis from Schrag et al. Intravenous Fibrinolytic Therapy in Central Retinal Artery Occlusion: A Patient-Level Meta-analysis. JAMA Neurol. ePub August 2015. Slide 14: Figure 6: Table 5: Inclusion criteria for EAGLE study, Schumacher et al. Central Retinal Artery Occlusion: Local Intra-arterial Fibrinolysis versus Conservative Treatment, a Multicenter Randomized Trial. Ophthalmology 2010;117:1367-1375. Slide 17: Figure 7: Angiogram before tPA administration. Minimal choroidal blush observed. Slide 18: Figure 8: Angiogram at time of tPA administration. Choroidal blush improved. Slide 20: Figure 9: Select diffusion weighted images from MRI Brain. Acute small foci of infarction involving the inferomedial aspect of the right cerebellar hemisphere, the deep white matter of the posterior right frontal lobe, cortical and juxtacortical white matter of the high convexity of the high convexity left parietal lobe likely embolic in origin Slide 21: Figure 10: Risk and Risk Periods for Stroke and Acute Myocardial Infarction in Patients with Central Retinal Artery Occlusion. from Park et al.. Ophthalmology 2015. Slide 22: Figure 11: Risk and Risk Periods for Stroke and Acute Myocardial Infarction in Patients with Central Retinal Artery Occlusion. from Park et al., Ophthalmology 2015. Slide 24: Figure 12: Table 6: Cardiovascular Risk Factors in Central Retinal Artery Occlusion - Results of a Prospective and Standardized Medical Examination. Top half of table highlights frequency of newly discovered risk factors after medical investigation. Bottom half of table highlights incidence of cardiovascular events, including 5 new strokes, 4 of which were within 1 month after central retinal artery occlusion. from Calizzo et al. Ophthalmology 2015;122:1881-1888.