Rodrigo Vilares-Morgado1,2,3, Hugo Miguel Meireles Nunes4, Ricardo Soares Dos Reis4,5,6,7, João Barbosa-Breda8,9,10. 1. Faculty of Medicine of the University of Porto, Porto, Portugal. vilaresmorgador@gmail.com. 2. Cardiovascular R&D Center, Faculty of Medicine of the University of Porto, Porto, Portugal. vilaresmorgador@gmail.com. 3. Department of Ophthalmology, Centro Hospitalar e Universitário São João, Porto, Portugal. vilaresmorgador@gmail.com. 4. Faculty of Medicine of the University of Porto, Porto, Portugal. 5. Department of Neurology, Centro Hospitalar e Universitário São João, Porto, Portugal. 6. i3S - Instituto de Investigação e Inovação em Saúde, Porto, Portugal. 7. Departamento de Neurociências Clínicas e Saúde Mental, Faculty of Medicine of the University of Porto, Porto, Portugal. 8. Cardiovascular R&D Center, Faculty of Medicine of the University of Porto, Porto, Portugal. 9. Department of Ophthalmology, Centro Hospitalar e Universitário São João, Porto, Portugal. 10. KULeuven, Research Group Ophthalmology, Department of Neurosciences, Leuven, Belgium.
Abstract
PURPOSE: To summarize the existing treatment options regarding central retinal artery occlusion (CRAO), branch retinal artery occlusion (BRAO), arteritic anterior ischemic optic neuropathy (AAION), non-arteritic anterior ischemic optic neuropathy (NAION), and ocular ischemic syndrome (OIS), proposing an approach to manage and treat these patients. METHODS: A systematic literature search of articles published since 1st January 2010 until 31st December 2020 was conducted using MEDLINE (PubMed), Scopus, and Web of Science. Exclusion criteria included case reports, non-English references, articles not conducted in humans, and articles not including diagnostic or therapeutic options. Further references were gathered through citation tracking, by hand search of the reference lists of included studies, as well as topic-related European society guidelines. RESULTS: Acute ocular ischemia, with consequent visual loss, has a variety of causes and clinical presentations, with prognosis depending on an accurate diagnosis and timely therapeutic implementation. Unfortunately, most of the addressed entities do not have a standardized management, especially regarding their treatment, which often lacks good quality evidence on whether it should or not be used to treat patients. CONCLUSION: Ophthalmologic signs and symptoms may be a warning sign of cardiovascular or cerebrovascular events, namely stroke. Most causes of acute ocular ischemia do not have a standardized management, especially regarding their treatment. Timely intervention is essential to improve the visual, and possibly vital, prognosis. Awareness must be raised among non-ophthalmologist clinicians that might encounter these patients. Further research should focus on assessing the benefit of the management strategies already being employed .
PURPOSE: To summarize the existing treatment options regarding central retinal artery occlusion (CRAO), branch retinal artery occlusion (BRAO), arteritic anterior ischemic optic neuropathy (AAION), non-arteritic anterior ischemic optic neuropathy (NAION), and ocular ischemic syndrome (OIS), proposing an approach to manage and treat these patients. METHODS: A systematic literature search of articles published since 1st January 2010 until 31st December 2020 was conducted using MEDLINE (PubMed), Scopus, and Web of Science. Exclusion criteria included case reports, non-English references, articles not conducted in humans, and articles not including diagnostic or therapeutic options. Further references were gathered through citation tracking, by hand search of the reference lists of included studies, as well as topic-related European society guidelines. RESULTS: Acute ocular ischemia, with consequent visual loss, has a variety of causes and clinical presentations, with prognosis depending on an accurate diagnosis and timely therapeutic implementation. Unfortunately, most of the addressed entities do not have a standardized management, especially regarding their treatment, which often lacks good quality evidence on whether it should or not be used to treat patients. CONCLUSION: Ophthalmologic signs and symptoms may be a warning sign of cardiovascular or cerebrovascular events, namely stroke. Most causes of acute ocular ischemia do not have a standardized management, especially regarding their treatment. Timely intervention is essential to improve the visual, and possibly vital, prognosis. Awareness must be raised among non-ophthalmologist clinicians that might encounter these patients. Further research should focus on assessing the benefit of the management strategies already being employed .