Thrombolysis for central retinal artery occlusion

Central retinal artery occlusion (CRAO) frequently causes severe and irreversible visual loss. For many years, various conservative treatments have been proposed for acute CRAO, but their efficacy remains unproven. Over the past 20 years, CRAO has also been treated with thrombolytic agents administered intravenously or intra-arterially. However, all thrombolytic studies are retrospective and uncontrolled, so that the benefit of this treatment remains uncertain. A prospective controlled clinical trial is ongoing in Europe and should provide more reliable information. Even if this trial demonstrates a benefit, thrombolytic treatment is unlikely to become widespread in the management of CRAO unless it can be deployed quickly after the event.