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Bayrampaşa Göz Hastanesi, İstanbul, Prof. Dr. Central Retinal Artery Occlusion is a painless entity characterized with suddenly vision loss. Embolus, vasoobliterasyon and compression are the causes of CRAO.
Clinical Signs: Afferent pupillary defect (Marcus Gunn), white retina, red fovea, vascular sclerosis, diameter differentiation in vessels, no blood circulation, segmented blood columns, seldom cilioretinal arteriole is affected and emboli are visible in %20 of eyes with CRAO.
Treatment: The aim of the treatment are to change the location of embolus, to dilate the vessels, to increase the blood circulation and oxygen saturation, to fragment the embolus and to remove the embolus. Various treatment modalities are used alone or in combination. There are some treatment processes and substances; ocular massage, supine position, paracentesis, acetazolamide, glyserin, topical beta blockers, IV mannitol, acetylsalicylic acid, pentoxifylline, corticosteroids, hemodilution, carbogen, hyperbaric oxygen therapy, heparin, retrobulbar tolazolin, enhanced external counterpulsation(EECP), streptokinase, urokinase, recombinant tissue-type plasminogen activator(rTPA), Nd YAG laser embolysis and surgical remove of embolus.
The optimum circumstances for Nd YAG laser embolisis; the existance of vessels feeding the parafoveal region, early cases and the existance of obliteration in FFA.
Streptokinase, urokinase and rTPA are used in Local Intraarterial Fibrinolysis(LIF). rTPA preferred because of low side effects and shortly duration of therapy. Lately, in some cases to remove the embolus surgically is gainning popularity.
Result: Every patient should be treated without regarding to the reason of the occlusion, duration and type. Keywords : Central retinal artery occlussion, surgical treatment