Efficacy of Thrombolytic, Laser, Anti-VEGF and Surgical Treatment in Retinal Artery Occlusion and Related Complications

Retinal artery occlusion (RAO) is characterized by sudden interruption of arterial blood flow in the retinal circulation and subsequent ischemic retinal injury. Retinal artery occlusion is divided into sub-forms such as central retinal artery occlusion (CRAO) and branch retinal artery occlusion (BRAO). Patients with CRAO present with sudden, painless and unilateral complete visual loss, while patients with BRAO present with partial or complete visual loss in relation to visual field damage. Thromboembolism is the non-arteritic form and the predominant mechanism in RAO; the form defined as arteritic RAO constitutes approximately 5% and is associated with inflammatory changes. Retinal artery occlusion is an ophthalmologic emergency where the most important factor in its treatment is timing and early interventions are very important. The conventional treatment methods aim to restore perfusion by reducing intraocular pressure or vasodilatation and to reduce ischemic damage. In order to achieve more favorable results in treatment, methods to directly open the obstruction caused by thromboembolism have been tried. These include thrombolytic therapy, laser and surgical treatment. At the same time, studies on the efficacy of anti-VEGF treatment in the emerging complications are ongoing. The aim of this review is to present a guideline for choosing the most appropriate treatment for RAT and related complications at the most appropriate time.