Central retinal artery occlusion in patients with cerobro vascular accident in a teaching hospital in rural Telangana, India

Karthika N., Bharath Madhavaram, Ashok Kumar


Background: Central retinal artery occlusion (CRAO) is a stroke of the eye caused by obstruction of the central retinal artery, usually by a thrombus or embolus that results in painless, disabling vision loss, hence it is an occular emergency. This study was done to know the visual outcomes in patients with CRAO.

Methods: An observational study was conducted on the patients admitted with cerebrovascular accident at MediCiti Institute of Medical Sciences over a period of 2yrs i.e. from January 2015 to December 2016. The study included 75 patients with Cerebro-Vascular Accident (CVA) that met the inclusion criteria for diagnosis of CRAO.

Results: A total of 75 cases with CVA admitted to the hospital were included in the study. The age group ranged from 50 to 80 years (median age 65 years). Among these, 64 cases were associated with hypertension and 46 cases with diabetes. Six patients (8%) had CRAO with sparing of cilio-retinal artery.

Conclusions: CRAO has a diverse etiology. It can vary from hypertension to even snake bite. As it is an occular emergency, Identification of under lying cause is essential during follow-up for better intervention.


Diabetes, Emboli, Hypertension, Stroke, Thrombus, Vision loss

Full Text:



Rumelt S, Dorenboim Y, Rehany U. Aggressive systematic treatment for central retinal artery occlusion. Am J Ophthalmol. 1999;128(6):733-8.

Chen CS, Lee AW. Management of acute central retinal artery occlusion. Nat Clin Pract Neurol. 2008;4(7):376-83.

Kollarits CR, Lubow M, Hissong SL. Retinal strokes. I. Incidence of carotid atheromata. JAMA. 1972;222(10):1273-5.

Schumacher M, Schmidt D, Jurklies B, Gall C, Wanke I, Schmoor C,Maier-Lenz H, et al. Central retinal artery occlusion: local intra-arterial fibrinolysis versus conservative treatment, a multicenter randomized trial. Ophthalmology. 2010;117(7):1367-75.

Hattenbach LO, Kuhli-Hattenbach C, Scharrer I, Baatz H: Intravenous thrombolysis with low-dose recombinant tissue plasminogen activator in central retinal artery occlusion. Am J Ophthalmol. 2008;146(5):700-6.

Kattah JC, Wang DZ, Reddy C: Intravenous recombinant tissue-type plasminogen activator thrombolysis in treatment of central retinal artery occlusion. Arch Ophthalmol. 2002;120(9):1234-6.

Augsburger JJ, Magargal LE: Visual prognosis following treatment of acute central retinal artery obstruction. Br J Ophthalmol. 1980;64(12):913-7.

Ffytche TJ. A rationalization of treatment of central retinal artery occlusion. Trans Ophthalmol Soc UK. 1974;94(2):468-79.

Schmidt D, Schumacher M, Feltgen N. Circadian incidence of non-inflammatory retinal artery occlusions. Graefes Arch Clin Exp Ophthalmol. 2009; 247(4):491-4.

Ratra D, Dhupper M. Retinal arterial occlusion in the young: systemic associations in Indian Population. Indian J Ophthalmol. 2012;60(2):95-100.

Kanchan Sawant, Ashis Ghosh, RP Gupta, S Patra. central retinal artery occlusion. Med J DY Patil Univ. 2012;5(1):69-70.

Shilpa YD, Kalpana BN, Sadiqulla M. Optical coherence tomogram and demographic profile in central retinal artery occlusion: A South Indian study. Egyptian Retina J. 2015;3(1):10-4.

Brown GC, Magargal LE, Shields JA, Goldberg RE, Walsh PN. Retinal arterial obstruction in children and young adults. Ophthalmol. 1981;88(1):18-25.

Greven CM, Slusher MM, Weaver RG. Retinal arterial occlusions in young adults. Am J Ophthalmol. 1995;120(6):776-83.

Hayreh SS, Podhajsky PA, Zimmerman MB. Retinal artery occlusion: Associated systemic and ophthalmic abnormalities. Ophthalmol. 2009;116:61-9.

Gass JD. Stereoscopic Atlas of Macular Diseases Diagnosis and Treatment. 4th ed. Mosby: Macular dysfunction caused by retinal vascular diseases; 1998:444.

Wong TY, Larsen EK, Klein R, Mitchell P, Couper DJ, Klein BE, et al. Cardiovascular risk factors for retinal vein occlusion and arteriolar emboli: The atherosclerosis risk in communities and cardiovascular health studies. Ophthalmol. 2005;112:540-7.

Wong TY, Klein R. Retinal arteriolar emboli: Epidemiology and risk of stroke. Curr Opin Ophthalmol. 2002;13(3):142-6.

Song YM, Shin SY. Bilateral ophthalmic artery occlusion in rhino-orbito-cerebral mucormycosis. Korean J Ophthalmol. 2008;22(1):66-9.