Central Retinal Artery Occlusion Treatment, Outcomes Improve With Point-of-Care Diagnosis

Point-of-care diagnosis of central retinal artery occlusion (CRAO) may improve time to treatment and outcomes, according to findings presented at the American Academy of Ophthalmology (AAO) 2022 meeting, held in Chicago from September 30 to October 3.

The study reports on the use of optical coherence tomography (OCT) for point-of-care diagnosis of CRAO and early outcomes of treatment. 

Researchers placed OCT machines in 3 stroke centers throughout the health system, and a stroke code was activated by patients who presented with painless, monocular vision loss. 

The stroke service acquired macular OCT images, which were transmitted electronically to the retina service with clinical data. Patients were brought directly for treatment with intra-arterial tissue plasminogen activator if the diagnosis was confirmed and patients could be treated within 12 hours of last known well. 

The researchers found 17 patients of 32 evaluated who had confirmed retinal artery occlusions. Of those, 5 met the criteria for treatment, with a mean door-to-injection time of 142 min, and mean time to treatment of 8.6 hours. 

At presentation, the mean visual acuity was logMAR 2.23 (20/3380), and the mean post-injection visual acuity was logMAR 0.49 (20/60). Four weeks after injection, the mean final visual acuity was logMAR 0.69 (20/100). No adverse reactions were reported.