RARE DISEASE
Central retinal artery occlusion
Central retinal artery occlusion
Central retinal artery occlusion
Synonyms: CRAO
Synonyms: CRAO
Synonyms: CRAO
Drug discovery
2
drugs
With orphan designations
Overview
Central retinal artery occlusion (CRAO) is an ophthalmic emergency characterized by sudden, painless monocular vision loss due to retinal ischemia, typically caused by thromboembolism from carotid/cardiac sources or vasculitis (e.g., giant cell arteritis). Diagnosis relies on funduscopy findings (pale retina, cherry-red spot, arterial attenuation) and systemic evaluation for embolic sources. Prognosis is poor, with <20% achieving functional visual recovery without timely intervention. Urgent referral to stroke centers is critical due to elevated cerebrovascular risk [1][4][9].
Therapies
Acute phase: Ocular massage, intraocular pressure reduction (topical timolol, IV acetazolamide), and hyperbaric oxygen (if <12 hours) [3][9][17].
Thrombolytics: IV or intra-arterial tPA within 4.5–6 hours may improve outcomes but lack robust evidence [7][9][12].
Secondary prevention: Antiplatelet therapy, statins, and management of vascular risk factors [4][6][9].
Categories: rare ophthalmic disorders
Research Papers
737 drug discovery papers about Central retinal artery occlusion, with 3 first-in-class and 2 next-in-class emerging drug candidates forecasted to outperform the average preclinical success rate. Recent publications:
737 drug discovery papers about Central retinal artery occlusion, with 3 first-in-class and 2 next-in-class emerging drug candidates forecasted to outperform the average preclinical success rate. Recent publications:
categories:
Small molecules
small molecules
2026-08-17 | Association of Metabolic Syndrome and Its Components with Retinal Artery Occlusion: An Epidemiologic and Genetic Analysis.
To examine the association between MetS, its five components (central obesity, hypertension, hyperglycemia, dyslipidemia, and hypertriglyceridemia) and RAO, and to assess whether genetic susceptibility to key components of the MetS (hypertension, hyperglycemia) interacts with these associations. Based on the UK Biobank, Cox proportional hazards regression models were applied to assess the associations between MetS, its individual components, and the incidence of RAO. Restricted cubic spline analysis was applied to determine non-linear trends in their associations. Polygenic risk scores of hypertension and diabetes were further used to assess the genetic interactions of MetS components with RAO. A total of 361,578 participants with a mean age of 55.94 years were included in the analysis. The risk of RAO was significantly higher in individuals with MetS (HR: 1.59, 95% CI: 1.05-2.42), as well as in those with its key components: hypertension (HR: 3.06, 95% CI: 1.52-6.16) and hyperglycemia (HR: 2.70, 95% CI: 1.27-3.83). Genetic analysis revealed that MetS was associated with a significantly increased risk of RAO in individuals with a higher genetic predisposition to T2DM (HR: 3.20, 95% CI: 2.23-4.17). MetS, especially its key components hypertension and hyperglycemia, increased the risks of RAO onset. Genetic susceptibility to T2DM also increased RAO risk in MetS patients. These findings indicate that MetS may serve as a valuable marker for the secondary prevention of RAO, and stringent management of hyperglycemia and hypertension could contribute to a reduced risk of RAO.
2026-08-14 | Impact of an eye-stroke protocol with non-mydriatic ocular imaging in an emergency department.
The diagnosis of acute central retinal artery occlusion (CRAO) and branch retinal artery occlusion (BRAO) is often delayed or missed in emergency departments (EDs) because of limited ocular funduscopic skills and lack of immediate ophthalmology access. We evaluated the clinical impact of our Eye-Stroke protocol using non-mydriatic ocular imaging (non-mydriatic fundus photography and optical coherence tomography [NMFP-OCT]) in our general ED with remote interpretation by ophthalmology on the time to diagnosis and emergent management of acute CRAO/BRAO. Prospective consecutive series of 100 acute CRAO/BRAOs seen within 1 week of vision loss between June 2023 and April 2026 with NMFP-OCT in our ED. Among 100 CRAO/BRAO eyes seen within 1 week of onset, 16 (16%) had vision loss within 4.5 h, 49 (49%) between 4.5 and 24 h, 35 (35%) between 24 h and 1 week (median times from presentation to NMFP-OCT 28.5 min [IQR, 17.75-57.5 min; range, 10-330 min], 96 min [IQR, 51-180 min; range; 9-317 min], and 134 min [IQR, 96-187 min; range, 30-337 min], respectively). The diagnosis of CRAO/BRAO was made from color photographs and OCT in 77/100 eyes, from OCT only in 19/100 eyes, and 3/100 eyes had uninterpretable imaging. 7/16 eyes presenting within 4.5 h of vision loss received intravenous thrombolysis (median door-to-needle time, 58 min [IQR, 46-78.5 min; range, 41-181 min]). The majority of the patients evaluated within 4.5 h were self-referred to our ED, whereas the majority of the patients presenting later were referred by outside providers or transferred from other EDs. Stroke workup found a major cause of CRAO/BRAO in 72%, and 17/94 (18%) had concurrent cerebral infarctions on brain magnetic resonance imaging (MRI). Despite our Eye-Stroke protocol, facilitated by NFMP-OCT in our ED, only 16% of acute CRAO/BRAO eyes were diagnosed early enough to be considered for intravenous (IV) thrombolysis, which was administered to only 43% of those eligible. Rapid workup found a major cause of CRAO/BRAO in 72%, and 18% had concurrent cerebral infarctions on MRI. The main barrier to delayed diagnosis/care was transfer from other institutions/providers, suggesting that wide deployment of NMFP-OCT for remote diagnosis and treatment via existing telestroke networks is optimal for reducing time to diagnosis, avoiding transfers, and improving patient outcomes.
2026-08-14 | Low-dose intravenous alteplase for acute retinal artery occlusion: A multicentre retrospective study.
Central retinal artery occlusion (CRAO) is an ophthalmic emergency with poor visual prognosis. Although intravenous thrombolysis (IVT) within 4.5 h may be beneficial, the effectiveness and safety of low-dose alteplase remain uncertain. We conducted a retrospective study at three centres in Japan, enrolling patients who presented within 24 h of onset with CRAO or macula-involving branch retinal artery occlusion (BRAO) between June 2021 and September 2024. Patients were analysed if they had baseline best-corrected visual acuity (BCVA) < 20/400, clearly defined symptom onset, absence of proliferative retinopathy or other retinal vascular diseases, and 30-day visual outcome data. Patients were grouped by treatment with IVT using alteplase at 0.6 mg/kg within 4.5 h or non-IVT management. The primary outcome was 30-day BCVA ≥ 20/100; secondary outcome included change in BCVA (logarithm of the minimum angle of resolution [logMAR]); and safety outcomes included intracranial hemorrhage (ICH). Sixteen of 41 registered patients were analysed (70.1 ± 12.6 years; 4 women; 13 had CRAO; 9 received IVT). The primary outcome was achieved in 22.2% (2/9) of the IVT group versus 0% (0/7) of the non-IVT group (p = 0.475). Improvement in logMAR was greater in the IVT than the non-IVT group (median difference 0.45 [95% confidence interval, 0.18-1.20]; p = 0.023). No symptomatic ICH occurred; one IVT-treated patient had asymptomatic ICH. IVT using low-dose alteplase within 4.5 h of CRAO (or macula-involving BRAO) onset may be associated with greater visual improvement without apparent safety concerns, although this requires confirmation by larger prospective studies.
2026-07-29 | Sight-saving outcome with thrombolysis in central retinal artery occlusion.
'Time is brain' is an important concept in ischaemic brain stroke, where expeditious intervention is essential for the preservation of neural tissue. Therapeutic strategies involve the prompt administration of thrombolytic agents and in select circumstances the implementation of mechanical thrombectomy. Central retinal artery occlusion (CRAO) constitutes an ophthalmological emergency and is a form of ischaemic stroke, frequently resulting in profound and irreversible visual impairment. There are currently no universally accepted guidelines delineating the optimal therapeutic time window. In this report, we present the case of a man in his 60s who developed acute, painless monocular vision loss, was rapidly diagnosed with CRAO and subsequently received intravenous tenecteplase and showed near-complete visual recovery within 1 week. This case demonstrates the importance of early interdisciplinary collaboration between ophthalmology and stroke teams and the need for establishment of standardised clinical pathways for the management of CRAO.
2026-07-07 | Central Retinal Artery Occlusion Following Intradialytic Hypotension in End-Stage Renal Disease
Central retinal artery occlusion (CRAO) is a vision-threatening ophthalmic emergency requiring rapid recognition and evaluation. Although embolic etiologies predominate, low-flow ischemia related to hemodynamic instability represents an underrecognized mechanism. We report the case of a 66-year-old woman with end-stage renal disease (ESRD) on hemodialysis who experienced recurrent transient right-eye visual symptoms near the end of dialysis sessions. She had chronic intradialytic hypotension, with systolic blood pressures ranging from 90 to 100 mmHg and post-dialysis pressures averaging 90/50 mmHg. Ophthalmologic examination demonstrated markedly reduced visual acuity in the right eye, normal intraocular pressures, full extraocular movements, and full confrontation visual fields bilaterally. Dilated fundus examination showed diffuse retinal pallor with a characteristic cherry-red spot, consistent with CRAO. Comprehensive evaluation, including carotid Doppler ultrasound, CT angiography of the head and neck, brain magnetic resonance imaging, and transthoracic echocardiography, revealed no embolic or large-vessel source. The event was attributed to recurrent intradialytic systemic hypoperfusion superimposed on impaired microvascular autoregulation from diabetes and cardiovascular disease. Management included antiplatelet therapy and optimization of intradialytic blood pressure, after which no further visual ischemic episodes were reported. This case highlights intradialytic hypotension as a potential nonembolic cause of CRAO in patients undergoing hemodialysis and underscores the importance of early recognition and hemodynamic optimization in this high-risk population.
proteins
2026-05-31 | Acute retinal artery occlusions.
Acute retinal artery occlusions present with sudden, painless monocular vision loss and are equivalent to cerebral strokes. The diagnosis is made on ocular fundus examination facilitated by fundus photography and optical coherence tomography. Management of acute retinal artery ischemia requires a collaborative approach among emergency department, ophthalmology, and stroke neurology providers. In the acute setting, patients should undergo a standard stroke evaluation. There are currently no widely accepted therapies for acute retinal artery occlusions. So-called "conservative treatments," such as anterior chamber paracentesis, ocular massage, and hemodilution, have no benefit and should not be pursued. Recent meta-analyses and reviews from experts have suggested a possible treatment effect for intravenous tPA within 4.5hours of vision loss or intra-arterial tPA within 6hours of vision loss for patients with acute central retinal artery occlusion. Ongoing clinical trials evaluating intravenous thrombolysis within 4.5hours of vision loss will hopefully provide definite answers. In the interim, it is essential to educate providers and patients about the importance of calling emergency services when experiencing acute vision loss to ensure immediate transfer to a facility affiliated with a stroke center, where timely diagnosis, evaluation, and treatment of acute retinal ischemia can occur.
2026-05-27 | GDF11 supplementation improved retinal structure and function in retinal ischemia injury.
Retinal ischemia is a major cause of blindness and plays a detrimental role in various diseases, including occlusion of arteries or veins, diabetic retinopathy, and ocular ischemic syndrome, which could lead to the neuronal and vascular dysfunction. As a result, maintaining their activities may help to avoid visual loss. Growth differentiation factor 11 (GDF11) has been implicated that exert neuroprotective effects and promote the angiogenesis after cerebral or cardiac ischemic injury. Here, we demonstrate that GDF11 has a protective effect on ischemia retinal injury. To simulate the morphological and functional results following retinal ischemia, a mouse unilateral common carotid artery occlusion (UCCAO) model was employed. Electroretinography (ERG) was conducted to assess the severity of retinal impairment. The effects were evaluated using hematoxylin and eosin (H&E)-staining and immunohistochemistry. In addition, angiogenic activity affected by retinal ischemia was assessed in vivo and in vitro models. We successfully established the UCCAO model and expanded the pathological understanding of UCCAO-induced retinal ischemia. The treatment with GDF11 attenuated cell death, retinal edema, gliosis and apoptosis processes in the acute phase after UCCAO. In addition, GDF11 further reduced apoptosis and improved angiogenesis in the chronic phase after UCCAO. Mechanistically, GDF11 exerted its protective effects by activating the phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT) pathway, underscoring its potential as a multifaceted therapeutic agent for retinal ischemia. Our study shows the potential of GDF11 as a novel therapeutic for recovering retinal function following retinal ischemia. The results reveal that the therapeutic benefits of GDF11 are exerted during the acute and chronic phases following retinal ischemic injury.
2026-04-21 | CD5L promotes efferocytosis and resolution of retinal ischemic injury.
Ischemia-induced retinopathy is a defining feature of prevalent ocular conditions, including diabetic retinopathy and central retinal artery or vein occlusion. Therapeutic interventions for ischemic retinopathies show limited efficacy and adverse effects, highlighting the need to thoroughly investigate the underlying mechanisms. Histone deacetylase 3 (HDAC3), a member of the histone deacetylase family, plays a central role in regulating gene expression in myeloid cells (microglia and macrophages). We recently showed that myeloid HDAC3 deletion promotes tissue repair and functional recovery after retinal ischemia-reperfusion (IR) injury via efferocytosis, a process by which myeloid cells engulf and clear apoptotic cells. Here, we investigated the mechanism by which myeloid HDAC3 deletion enhances efferocytosis. Employing an in vitro efferocytosis assay coupled with RNA sequencing on HDAC3 KO macrophages revealed that the secreted protein, CD5 molecule-like (CD5L), was the most upregulated among other pro-efferocytic genes. In vivo, we found that CD5L levels markedly increased in the retinas of myeloid HDAC3 KO mice subjected to IR injury, and its expression colocalized with myeloid cells. Co-immunoprecipitation experiments showed that HDAC3 represses CD5L expression in a liver X receptor (LXRα)-dependent manner. Additionally, we found that CD36, a receptor for CD5L that facilitates the clearance of apoptotic cells, was upregulated in retinal myeloid cells after IR. In vitro, CD5L treatment enhanced efferocytosis via CD36. We then evaluated the role of CD5L in retinal IR injury using in vivo neuronal, vascular, structural, and functional endpoints. CD5L KO mice showed worsened outcomes after IR, whereas treatment with recombinant CD5L was protective against retinal ischemic injury. Collectively, our findings suggest that deleting HDAC3 enhances macrophage efferocytosis by upregulating the CD5L/CD36 axis. CD5L may serve as a promising therapeutic target to improve outcomes in ischemic retinopathy.
2026-04-02 | Update on Acute Retinal Arterial Ischemic Disorders.
Acute retinal artery occlusions present with sudden painless monocular vision loss and are homologous to cerebral ischemic strokes. The diagnosis is made on ocular fundus examination facilitated by fundus photography and optical coherence tomography. In the acute setting, patients should undergo a standard stroke evaluation, in addition to workup for possible giant cell arteritis in patients aged 50 years and older. Recent meta-analyses of observational studies have suggested a potential positive treatment effect for intravenous tPA when delivered within 4.5 hours of symptom onset. Analyses of clinical trials evaluating intravenous thrombolysis within 4.5 hours of vision loss are ongoing.
2025-10-16 | Visual outcome comparison of intravenous thrombolysis after central retinal artery occlusions.
Central retinal artery occlusions (CRAOs) are an important cause of vision loss that lacks standardized emergent treatment. While intravenous thrombolysis is effective in acute ischemic stroke, its safety and efficacy in CRAOs remain unclear. This study compares visual outcomes of patients with CRAOs treated with intravenous thrombolysis versus medical management (MM). A retrospective cohort study was done of patients with acute CRAOs presenting with count fingers or worse. Patients receiving thrombolysis tenecteplase (TNK) or tissue plasminogen activator (tPA)] were matched to those who received MM without thrombolysis based on age, gender, hypertension, diabetes, and hyperlipidemia. Groups included 20 TNK, 19 tPA, and 39 MM patients. Primary outcomes were average visual acuity (logMAR) and proportion of patients with >20/200 vision at initial and final visit within 6 months of CRAO diagnosis. Multivariate regression controlled for demographics, comorbidities, and non-thrombolytic treatments. Better than 20/200 vision was more common in those who received TNK than MM at first follow-up [OR: 6.70, 95 % CI: (1.25, 46.4), p = 0.04]. Similarly, patients receiving TNK had significantly better average visual acuity compared to MM on the first (-0.60 logMAR difference (95 % CI: (-1.0, -0.16), p = 0.008) and final (-0.60 logMAR difference 95 % CI: (-1.1, -0.12), p = 0.01) follow-up. No symptomatic intracranial hemorrhages or intraocular hemorrhages occurred within one week following treatment. Patients who received TNK had better visual outcomes than those treated with MM, a difference that was not seen with tPA use. These findings demonstrate a possible role for TNK in the management of CRAOs.
antibodies
2026-03-27 | Comparative peripheral inflammatory biomarker profiles in central and branch retinal artery occlusion: a retrospective study.
Retinal artery occlusion (RAO), including central retinal artery occlusion (CRAO) and branch retinal artery occlusion (BRAO), is an ophthalmic emergency and an important marker of systemic vascular disease. Inflammation plays a key role in RAO pathogenesis; however, subtype-specific inflammatory profiles remain insufficiently characterized. We conducted a retrospective observational study of 363 patients diagnosed with RAO at Renmin Hospital of Wuhan University between January 2020 and April 2024 (CRAO, n = 320; BRAO, n = 43). Peripheral inflammatory biomarkers, including leukocyte count, neutrophil percentage, lymphocyte percentage, monocyte percentage, eosinophil percentage, C-reactive protein (CRP, mg/L), and neutrophil-to-lymphocyte ratio (NLR), were compared between CRAO and BRAO using independent-sample t tests or Mann-Whitney U tests, as appropriate. Sex- and age-stratified analyses were performed to explore subgroup patterns. A modest shift was observed between BRAO, CRAO patients in term leukocyte counts (6.57 ± 2.19 vs. 5.95 ± 1.66 × 10⁹/L; p = 0.03) and lymphocyte (30.75 ± 8.62% vs. 27.32 ± 7.52%; p = 0.01), but lower neutrophil percentages (58.33 ± 9.08% vs. 61.92 ± 8.07%; p = 0.01). These between-group differences were small, and group-level means largely remained within conventional reference ranges. Monocyte and eosinophil percentages did not differ significantly between groups. CRP levels (mg/L) showed no statistically significant difference, although greater variability was observed in the CRAO group. In patients with available absolute counts, BRAO demonstrated a higher NLR than CRAO. Sex- and age-stratified analyses revealed consistent subtype-related differences, with more pronounced neutrophil-lymphocyte shifts in males and steeper age-related changes in CRAO. CRAO and BRAO exhibit distinct systemic inflammatory profiles. CRAO is characterized by higher leukocyte and lymphocyte levels, suggesting broader systemic inflammatory involvement, whereas BRAO demonstrates relative neutrophil predominance and higher NLR, consistent with a more localized inflammatory response. These findings support the concept that CRAO and BRAO are immunologically distinct entities and may benefit from subtype-specific evaluation and management strategies. Prospective, multi-center studies are warranted to validate these observations and clarify their clinical implications.
2025-12-15 | Combined Treatment of Hyperbaric Oxygen and Anti-vascular Endothelial Growth Factor Therapy in Cilioretinal Artery Occlusion Associated With Central Retinal Vein Occlusion.
We report a case of a male in his early 40s who presented with transient episodes of visual blurring and was initially diagnosed with isolated cilioretinal artery occlusion (CLRAO). Hyperbaric oxygen therapy (HOT) was initiated on the same day as the onset of the preceding episode, and six sessions had been completed when he was first examined at our department. Despite ongoing HOT, he developed worsening signs of venous stasis. Further investigation confirmed CLRAO secondary to central retinal vein occlusion (CRVO) and revealed heterozygosity for the factor V Leiden mutation. HOT was continued for two weeks, and a single intravitreal injection of bevacizumab (anti-vascular endothelial growth factor (anti-VEGF)) was administered, resulting in full and sustained anatomical and functional recovery, with visual acuity improving from 8/10 to 10/10. This case supports the benefit of anti-VEGF therapy in combined CLRAO and CRVO without exudative or neovascular complications, by promoting vasoconstriction and reducing venous permeability. It also suggests a synergistic effect with HOT by further lowering retinal venous pressure through distinct mechanisms. These findings highlight the potential benefit of addressing both retinal hypoxia and venous hypertension through the combined use of HOT and anti-VEGF therapy in selected cases of mixed retinal vascular occlusion.
2025-11-11 | When vision loss signals vasculitis: central retinal artery occlusion leading to microscopic polyangiitis diagnosis-a case report.
Central retinal artery occlusion (CRAO) is an ophthalmic emergency characterized by sudden vision loss; it is rarely associated with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. Herein, we report a case of a man in his 80s who, experiencing persistent fever, weight loss, and myalgia, received corticosteroid therapy at a local hospital for a presumptive diagnosis of polymyalgia rheumatica. While on this treatment, he suddenly developed vision loss in the left eye; visual acuity was limited to light perception, and fundus examination revealed a cherry-red spot in the macula, consistent with CRAO. The patient was urgently referred and admitted to the rheumatology department of our hospital for evaluation and management of suspected systemic vasculitis underlying CRAO. The presence of persistent fever, elevated inflammatory markers, positive myeloperoxidase-ANCA, interstitial lung disease, purpura, and small-vessel vasculitis confirmed via muscle biopsy led to the diagnosis of microscopic polyangiitis. Given this clinical course and definitive diagnosis, his initial systemic symptoms were considered early manifestations of the underlying microscopic polyangiitis. The patient was treated with methylprednisolone pulse therapy and rituximab, followed by azathioprine; the inflammatory markers improved, and visual acuity recovered to hand motion by discharge. This case highlights that when CRAO occurs alongside systemic symptoms, ANCA-associated vasculitis should be strongly considered as a potential underlying cause. Timely identification of such systemic vasculitis is crucial to enhance the possibility of visual recovery and to reduce complications affecting vital organs beyond the eye.
2025-07-10 | Neovascular Proliferation over a Cosmetic Artificial Iris Implant.
The NewColorIris and BrightOcular implants were initially developed to address congenital iris defects. However, they found application for cosmetic purposes. Unfortunately, these implants are frequently linked to severe complications, including glaucoma, endothelial dysfunction, cataract development, and iris abnormalities. In this context, we present an unusual complication that manifested long after the implantation of the BrightOcular artificial iris. A 28-year-old woman presented to our emergency room with blurred vision in both eyes. She had undergone bilateral cosmetic iris implantation (BrightOcular, Stellar Devices, New York, NY, USA) 6 years earlier in Tunisia. At the first examination, her best corrected visual acuity was hand motion in the right eye and 20/100 in the left eye, and intraocular pressure (IOP) was 45 mm Hg and 30 mm Hg, respectively. Despite the maximum-tolerated glaucoma medical treatment, the elevated IOP persisted, leading to the decision to perform bilateral sequential Baerveldt glaucoma drainage device implantation. However, she subsequently developed combined central retinal artery and vein occlusion in the right eye and hypotensive maculopathy in the left eye; the latter resolving within 1 month. Two months post-surgery, extensive neovascularization above the implant of the right eye was observed, and this was successfully treated with three sequential injections of bevacizumab. Cosmetic iris implantation is associated with severe, sight-threatening complications. Herein, we describe a previously unreported case of angle neovascularization with new vessels growing over the artificial iris implant. The condition regressed after intravitreal anti-vascular endothelial growth factor injections.
2025-02-12 | Sequential central retinal artery occlusion in two brothers: a fight to prevent blindness.
Central retinal artery occlusion (CRAO) is typically associated with older patients with cardiovascular risk factors. However, its occurrence in younger patients without these risk factors suggests the need to explore rare genetic conditions. Identifying genetic disorders like adenosine deaminase 2 deficiency (DADA2), a vasculitic disease, can be critical in such cases to prevent further complications. To report the challenging diagnosis of two cases of CRAO in brothers under the age of 40, leading to the diagnosis of DADA2, a rare genetic vasculitic disorder. A 34-year-old man and his 32-year-old brother, both without significant medical histories, presented with CRAO eight years apart. Extensive diagnostic evaluations, including blood tests, imaging, and autoimmunity panels, failed to identify common causes. Progressive neurological symptoms in the older brother and the similar presentation in his sibling led to further investigation, including genetic testing. A homozygous mutation c.752C > T p.(Pro251Leu) in the CECR1 gene confirmed the diagnosis of DADA2 in both brothers. These cases underscore the importance of considering genetic disorders like DADA2 in young patients presenting with unexplained vascular occlusions. DADA2, characterized by vasculitis, immune dysregulation, and hematologic disorders, can manifest variably, complicating early diagnosis. Effective treatment with TNF inhibitors can prevent further vision loss and mitigate systemic complications. To our knowledge, these are the first reported cases of DADA2 with CRAO as the initial manifestation without prior clinical findings.
gene therapies
2026-08-10 | Combined Central Retinal Artery Occlusion, Central Retinal Vein Occlusion, and Anterior Ischemic Optic Neuropathy Following Herpes Zoster Ophthalmicus: A Case Report
International audience
2026-05-06 | Retinal Ischemic Perivascular Lesions in the Fellow Eyes of Patients with Central Retinal Artery Occlusion.
To evaluate the prevalence and characteristics of retinal ischemic perivascular lesions (RIPLs) in the clinically unaffected fellow eyes of patients with unilateral central retinal artery occlusion (CRAO) using spectral-domain optical coherence tomography (SD-OCT). This retrospective case-control study included 39 fellow eyes of patients with CRAO and 57 age-, sex-, and hypertension-matched healthy controls. Macular SD-OCT scans were assessed for the presence, number, and morphology of RIPLs, classified as narrow (<300 µm, peaked apex) or wide (>300 µm, flattened apex). Between-group comparisons were performed using appropriate parametric/non-parametric tests, and odds ratios (ORs) were calculated for RIPL presence. RIPLs were detected in 29/39 eyes (74.4%) in the CRAO fellow-eye group and 14/57 eyes (24.6%) in controls (p < 0.001). The mean number of lesions per eye was significantly higher in the CRAO group (1.36 ± 1.22) than in controls (0.35 ± 0.73; p < 0.001). Among CRAO fellow eyes with RIPLs, 5 eyes (17.2%) showed wide-type lesions, whereas all lesions in controls were narrow. The odds of RIPL presence were higher in the CRAO group (OR 8.12, 95% CI 3.20-20.57; p < 0.001). Increased RIPL burden in the fellow eyes of CRAO patients suggests that microstructural retinal changes may be detectable even in eyes without clinically evident arterial occlusion. Further longitudinal, multimodal studies are needed to determine the temporal course and underlying mechanisms.
2026-05-01 | Post-mortem fundus photographs in sudden unexpected death in infancy: An overview of the typical findings.
To show post-mortem fundus photograph (PMFP) features seen in sudden unexpected death in infancy (SUDI), to detect retinal hemorrhages, which are a crucial hallmark for abusive head trauma (AHT). Single-center, retrospective study with SUDI cases included by a French SUDI referral center in the French national registry for SUDI cases between 2017 and 2025. All available PMFP, the final diagnosis and the post-mortem interval between death and PMFP were collected. Of the 78 SUDI cases recorded in Nantes, 65 underwent a fundus examination, of which 46 had PMFP available. The mean age at death was 4.5 ± 4.9 months, 30 children were male (65%). The main PMFP features were retinal changes resembling central retinal artery occlusion and macular and/or peripheral white radial retinal folds. The presence of a macular fold was associated with a longer post-mortem interval (presence versus absence of a macular fold: 12.2 ± 7.2 h [range: 4-30] versus 4.5 ± 1.6 h [range: 3-9], p < 0.001). Retinal hemorrhages were found in four non-abusive cases with non-specific fundus features and in two confirmed AHT cases, with AHT-suggestive features. The normal post-mortem fundus in children under two years old shows a "central retinal artery occlusion" pattern, followed by the appearance of macular or peripheral white radial retinal folds, that should not be mistaken for circumferential perimacular retinal folds and hemorrhagic retinoschisis cavities that have been described in AHT cases. PMFP allow detecting and documenting retinal hemorrhages, which may be indicative of infanticide.
2026-03-24 | Risk of retinal artery occlusion in patients with primary open-angle glaucoma: a retrospective cohort study.
BACKGROUND: To evaluate the risk of Retinal Artery Occlusion (RAO) in individuals with Primary-Open Angle Glaucoma (POAG) using a large-scale real-world database. METHODS: This retrospective cohort study used the TriNetX Global Collaborative Network to analyze electronic health records from 145 healthcare organizations. Adults aged 18 years or older with POAG were compared with non-POAG controls. Propensity score matching (PSM) was performed 1:1 on 10 baseline characteristics. The primary outcome was incident RAO occurring from one day after the index POAG diagnosis up to 5 years of follow-up. Hazard ratios (HRs) were calculated using Cox proportional hazard models. Kaplan-Meier analysis was conducted to compare RAO-free survival using log-rank tests. RESULTS: After PSM, there were 260,677 patients in each cohort (50.9% female; mean age 68.2 years). POAG patients had a significantly increased risk of RAO compared with controls (3.46 vs. 1.94 per 10,000; HR 2.16; 95% CI, 1.94–2.42; p < .001). The association persisted in sex-stratified and extended follow-up analyses. Anti-glaucoma medications did not significantly alter risk. CONCLUSIONS: This large-scale cohort study identifies POAG as an independently associated risk marker for RAO. These findings highlight the importance of vascular risk assessment in POAG management and highlight the need for increased vigilance for retinal ischemic events in this population.
2026-01-24 | Ocular injuries and the most common acute conditions in ophthalmology.
Ocular traumas include a wide range of injuries from trivial conditions to extensive perforating injuries that can lead to visual function impairment of various ranges and even to the loss of the eye itself. In terms of first aid, not only an ophthalmologist but also a physician of any specialty can effectively intervene and minimize the consequences of these conditions. Open globe injuries represent prognostically the most severe conditions which have to be treated by an experienced ophthalmologist. Closed injuries are most commonly manifested as corneal erosions, foreign bodies on the surface of a globe or contusions of varying severity. These conditions do not always require urgent primary intervention by an ophthalmologist. The opposite is true for chemical traumas which are often caused by alkali. Urgent intervention consisting in eye lavage is crucial to minimize complications. Periocular tissue injuries can be divided into orbital skeletal fractures and soft tissue traumas of the orbit and eyelids. Acute conditions in ophthalmology also include inflammations of the eye and periocular tissue, of which endophthalmitis and retroseptal orbital cellulitis are the most prognostically serious. Acute retinal circulatory disorders include central retinal artery occlusion and acute ischemic optic neuropathy. Acute angle-closure crisis can be manifested as sudden severe pain of the globe, headache and blurred vision. The other most common causes of acute visual impairment are hemophtalmus and retinal detachment, the conditions which require specialized intervention of an ophthalmologist. Sudden conditions in ophthalmology require prompt diagnosis and early basic medical intervention which can be provided by a physician of any specialty and can significantly reduce subsequent complications. Ultimate treatment then belongs to the ophthalmologist.
other
2026-07-12 | Reinforced double-layer vein patch angioplasty in carotid endarterectomy to mitigate patch aneurysm.
Carotid endarterectomy with patch angioplasty is standard for symptomatic carotid stenosis. However, prosthetic patches carry a risk of infection, particularly in patients with recent endocarditis. We report the case of a 67-year-old man who presented with central retinal artery occlusion and active mitral valve vegetation and subsequently underwent left carotid endarterectomy using a dual-layer facial vein patch. The harvested facial vein was everted to create a reinforced, double-layered conduit that was used for patch angioplasty, thereby avoiding prosthetic material. The patient awoke neurologically intact and 1-month duplex ultrasound demonstrated no residual stenosis or aneurysmal degeneration. Dual-layer everted cervical vein patches may provide a safe and durable autologous option in high-risk infectious settings.
2025-02-11 | Transfer of Mitochondria from Healthy Stem Cells to Injured Cells in Stroke with Retinal Impairments.
Stroke is the second leading cause of mortality worldwide, with retinal ischemia as its prominent complication. However, the pathology of retinal ischemia has not been fully elucidated, resulting in a lack of effective treatment. Stem cell therapy has been suggested to be therapeutic in retinal ischemia, with mitochondrial transfer potentially one of the underlying mechanisms. To investigate the mitochondrial function in retinal ischemia and the potential of mitochondrial transfer from mesenchymal stem cells (MSCs), in vivo middle cerebral artery occlusion (MCAO) model and in vitro oxygen-glucose deprivation (OGD) model were utilized in combination. In vivo, rats subjected to MCAO were randomly administered intravenous MSCs or vehicles. Laser doppler was used to measure the blood flow in the brain and the eye, along with immunohistochemical staining for assessing cellular degeneration. In vitro, retinal pigment epithelium (RPE) cells exposed to OGD were cocultured with or without MSCs. Mitochondrial function was measured by mitochondrial respiration, mitochondrial network analysis, mitochondria live cell imaging, and immunocytochemistry. The results demonstrated improved cell survival and restored mitochondrial function following MSC therapy. This chapter details the protocols necessary to produce the in vivo and in vitro models of ischemic stroke along with an assessment of mitochondrial function. Elucidating the mechanisms of mitochondrial transfer will further the knowledge in regenerative medicine and may enable new targets of therapeutics for stroke, especially for retinal ischemia.
2022-08-28 | Major clinical findings of cellular therapy for intravitreal use in ischemic retinopathy and macular degeneration: a systematic review
Introduction: In the scenario of eye diseases, diabetic retinopathy and retinal vein occlusion are the two most common ischemic retinopathies in the world. Ischemia is caused by retinal vascular diseases due to decreased blood perfusion and the appearance of areas of retinal non-perfusion. Also, age-related macular degeneration (AMD) is the most common cause of irreversible vision loss in people over 65 years of age in industrialized countries. By 2020, around 200 million people will be affected by AMD worldwide. Objective: the present systematic review study aimed to highlight the main clinical findings of the treatment of ischemic retinopathy and age-related macular degeneration through cell therapy with bone marrow stem cells. Methods: The rules of the Systematic Review-PRISMA Platform were followed. The search was carried out from March 2022 to June 2022 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument. The risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: It was found 235 articles involving retinitis pigmentosa, macular degeneration, and bone marrow stem cell therapy. A total of 51 were fully evaluated and 28 studies were included and developed in a systematic review in the results field. The symmetrical Funnel Plot does not suggest a risk of bias between the small sample size studies. It was concluded that intravitreal injection of bone marrow-derived stem cells in a patient with retinal vascular occlusion sequelae demonstrated that the procedure is feasible and safe to be performed in humans as there were no signs of infection, inflammation, or development of intraocular tumor formation. Also, neurotrophic effects correlate with vasculature preservation, suggesting that bone marrow-derived stem cells can be used in the treatment of diseases such as retinal degenerations and vasculopathy that currently lack effective treatment. The authors concluded that stem cells can protect retinal cells from degeneration and also suggested that they were able to replace some types of lost retinal neurons.
2022-03-24 | Oxidative stress facilitates exogenous mitochondria internalization and survival in retinal ganglion precursor-like cells
Ocular cells are highly dependent on mitochondrial function due to their high demand of energy supply and their constant exposure to oxidative stress. Indeed, mitochondrial dysfunction is highly implicated in various acute, chronic, and genetic disorders of the visual system. It has recently been shown that mitochondrial transplantation (MitoPlant) temporarily protects retinal ganglion cells (RGCs) from cell death during ocular ischemia. Here, we characterized MitoPlant dynamics in retinal ganglion precursor-like cells, in steady state and under oxidative stress. We developed a new method for detection of transplanted mitochondria using qPCR, based on a difference in the mtDNA sequence of C57BL/6 and BALB/c mouse strains. Using this approach, we show internalization of exogenous mitochondria already three hours after transplantation, and a decline in mitochondrial content after twenty four hours. Interestingly, exposure of target cells to moderate oxidative stress prior to MitoPlant dramatically enhanced mitochondrial uptake and extended the survival of mitochondria in recipient cells by more than three fold. Understanding the factors that regulate the exogenous mitochondrial uptake and their survival may promote the application of MitoPlant for treatment of chronic and genetic mitochondrial diseases.
2022-02-17 | Histological Assessment of Rat Retinas with Ischemia-Reperfusion Injury.
Retinal ischemia-reperfusion (IR) injury occurs in pathological situations that interrupt the blood flow to the retina, such as is the case during central retinal artery occlusion (CRAO). The animal models described in the literature are based on the pressure produced by the weight of a given quantity of saline elevated to a certain height; however, to establish these parameters it is necessary to perform mathematical calculations that cannot be easily redone in the case of punctual variations of intraocular pressure (IOP). The aim of this study was to present a new system that allows us to reproduce the conditions of retinal IR and thereby properly assess the level of injury in retinal histological samples. We developed a retinal IR model in WAG/RijHsd rats based on CRAO through increasing IOP. To develop this model, we produced ischemia for 1 h using a hydrostatic pressure system that maintained a constant high IOP and then allowed reperfusion for 1 h. The injury attributable to IR was assessed by histological examination of retinal samples, determining whether there was histological damage and/or dendritic swelling and counting the outer nuclear layer cells showing cytoplasmic swelling. The increase in IOP to 150 mm Hg produced CRAO, in turn causing observable histological damage and dendritic swelling in all retinas subjected to IR. Counting the number of cells showing cytoplasmic swelling yielded a mean of 102.5 ± 35 cells/field. The contralateral retinas were healthy, showing no significant changes. The retinal IR model proposed is simple, reproducible, and allows variable durations of ischemia and reperfusion, and most importantly, it allows easy correction by adjusting the pressure of the sphygmomanometer, of any change in IOP to keep the ischemia stable, without having to recalculate the elevation height of the ischemia induction system. Moreover, the damage caused by IR can be effectively assessed by the type of histopathological assessment performed. For these reasons, it can be considered a reliable method for studying drugs that may prevent retinal IR injury.
small molecules
2026-08-17 | Association of Metabolic Syndrome and Its Components with Retinal Artery Occlusion: An Epidemiologic and Genetic Analysis.
To examine the association between MetS, its five components (central obesity, hypertension, hyperglycemia, dyslipidemia, and hypertriglyceridemia) and RAO, and to assess whether genetic susceptibility to key components of the MetS (hypertension, hyperglycemia) interacts with these associations. Based on the UK Biobank, Cox proportional hazards regression models were applied to assess the associations between MetS, its individual components, and the incidence of RAO. Restricted cubic spline analysis was applied to determine non-linear trends in their associations. Polygenic risk scores of hypertension and diabetes were further used to assess the genetic interactions of MetS components with RAO. A total of 361,578 participants with a mean age of 55.94 years were included in the analysis. The risk of RAO was significantly higher in individuals with MetS (HR: 1.59, 95% CI: 1.05-2.42), as well as in those with its key components: hypertension (HR: 3.06, 95% CI: 1.52-6.16) and hyperglycemia (HR: 2.70, 95% CI: 1.27-3.83). Genetic analysis revealed that MetS was associated with a significantly increased risk of RAO in individuals with a higher genetic predisposition to T2DM (HR: 3.20, 95% CI: 2.23-4.17). MetS, especially its key components hypertension and hyperglycemia, increased the risks of RAO onset. Genetic susceptibility to T2DM also increased RAO risk in MetS patients. These findings indicate that MetS may serve as a valuable marker for the secondary prevention of RAO, and stringent management of hyperglycemia and hypertension could contribute to a reduced risk of RAO.
2026-08-14 | Impact of an eye-stroke protocol with non-mydriatic ocular imaging in an emergency department.
The diagnosis of acute central retinal artery occlusion (CRAO) and branch retinal artery occlusion (BRAO) is often delayed or missed in emergency departments (EDs) because of limited ocular funduscopic skills and lack of immediate ophthalmology access. We evaluated the clinical impact of our Eye-Stroke protocol using non-mydriatic ocular imaging (non-mydriatic fundus photography and optical coherence tomography [NMFP-OCT]) in our general ED with remote interpretation by ophthalmology on the time to diagnosis and emergent management of acute CRAO/BRAO. Prospective consecutive series of 100 acute CRAO/BRAOs seen within 1 week of vision loss between June 2023 and April 2026 with NMFP-OCT in our ED. Among 100 CRAO/BRAO eyes seen within 1 week of onset, 16 (16%) had vision loss within 4.5 h, 49 (49%) between 4.5 and 24 h, 35 (35%) between 24 h and 1 week (median times from presentation to NMFP-OCT 28.5 min [IQR, 17.75-57.5 min; range, 10-330 min], 96 min [IQR, 51-180 min; range; 9-317 min], and 134 min [IQR, 96-187 min; range, 30-337 min], respectively). The diagnosis of CRAO/BRAO was made from color photographs and OCT in 77/100 eyes, from OCT only in 19/100 eyes, and 3/100 eyes had uninterpretable imaging. 7/16 eyes presenting within 4.5 h of vision loss received intravenous thrombolysis (median door-to-needle time, 58 min [IQR, 46-78.5 min; range, 41-181 min]). The majority of the patients evaluated within 4.5 h were self-referred to our ED, whereas the majority of the patients presenting later were referred by outside providers or transferred from other EDs. Stroke workup found a major cause of CRAO/BRAO in 72%, and 17/94 (18%) had concurrent cerebral infarctions on brain magnetic resonance imaging (MRI). Despite our Eye-Stroke protocol, facilitated by NFMP-OCT in our ED, only 16% of acute CRAO/BRAO eyes were diagnosed early enough to be considered for intravenous (IV) thrombolysis, which was administered to only 43% of those eligible. Rapid workup found a major cause of CRAO/BRAO in 72%, and 18% had concurrent cerebral infarctions on MRI. The main barrier to delayed diagnosis/care was transfer from other institutions/providers, suggesting that wide deployment of NMFP-OCT for remote diagnosis and treatment via existing telestroke networks is optimal for reducing time to diagnosis, avoiding transfers, and improving patient outcomes.
2026-08-14 | Low-dose intravenous alteplase for acute retinal artery occlusion: A multicentre retrospective study.
Central retinal artery occlusion (CRAO) is an ophthalmic emergency with poor visual prognosis. Although intravenous thrombolysis (IVT) within 4.5 h may be beneficial, the effectiveness and safety of low-dose alteplase remain uncertain. We conducted a retrospective study at three centres in Japan, enrolling patients who presented within 24 h of onset with CRAO or macula-involving branch retinal artery occlusion (BRAO) between June 2021 and September 2024. Patients were analysed if they had baseline best-corrected visual acuity (BCVA) < 20/400, clearly defined symptom onset, absence of proliferative retinopathy or other retinal vascular diseases, and 30-day visual outcome data. Patients were grouped by treatment with IVT using alteplase at 0.6 mg/kg within 4.5 h or non-IVT management. The primary outcome was 30-day BCVA ≥ 20/100; secondary outcome included change in BCVA (logarithm of the minimum angle of resolution [logMAR]); and safety outcomes included intracranial hemorrhage (ICH). Sixteen of 41 registered patients were analysed (70.1 ± 12.6 years; 4 women; 13 had CRAO; 9 received IVT). The primary outcome was achieved in 22.2% (2/9) of the IVT group versus 0% (0/7) of the non-IVT group (p = 0.475). Improvement in logMAR was greater in the IVT than the non-IVT group (median difference 0.45 [95% confidence interval, 0.18-1.20]; p = 0.023). No symptomatic ICH occurred; one IVT-treated patient had asymptomatic ICH. IVT using low-dose alteplase within 4.5 h of CRAO (or macula-involving BRAO) onset may be associated with greater visual improvement without apparent safety concerns, although this requires confirmation by larger prospective studies.
2026-07-29 | Sight-saving outcome with thrombolysis in central retinal artery occlusion.
'Time is brain' is an important concept in ischaemic brain stroke, where expeditious intervention is essential for the preservation of neural tissue. Therapeutic strategies involve the prompt administration of thrombolytic agents and in select circumstances the implementation of mechanical thrombectomy. Central retinal artery occlusion (CRAO) constitutes an ophthalmological emergency and is a form of ischaemic stroke, frequently resulting in profound and irreversible visual impairment. There are currently no universally accepted guidelines delineating the optimal therapeutic time window. In this report, we present the case of a man in his 60s who developed acute, painless monocular vision loss, was rapidly diagnosed with CRAO and subsequently received intravenous tenecteplase and showed near-complete visual recovery within 1 week. This case demonstrates the importance of early interdisciplinary collaboration between ophthalmology and stroke teams and the need for establishment of standardised clinical pathways for the management of CRAO.
2026-07-07 | Central Retinal Artery Occlusion Following Intradialytic Hypotension in End-Stage Renal Disease
Central retinal artery occlusion (CRAO) is a vision-threatening ophthalmic emergency requiring rapid recognition and evaluation. Although embolic etiologies predominate, low-flow ischemia related to hemodynamic instability represents an underrecognized mechanism. We report the case of a 66-year-old woman with end-stage renal disease (ESRD) on hemodialysis who experienced recurrent transient right-eye visual symptoms near the end of dialysis sessions. She had chronic intradialytic hypotension, with systolic blood pressures ranging from 90 to 100 mmHg and post-dialysis pressures averaging 90/50 mmHg. Ophthalmologic examination demonstrated markedly reduced visual acuity in the right eye, normal intraocular pressures, full extraocular movements, and full confrontation visual fields bilaterally. Dilated fundus examination showed diffuse retinal pallor with a characteristic cherry-red spot, consistent with CRAO. Comprehensive evaluation, including carotid Doppler ultrasound, CT angiography of the head and neck, brain magnetic resonance imaging, and transthoracic echocardiography, revealed no embolic or large-vessel source. The event was attributed to recurrent intradialytic systemic hypoperfusion superimposed on impaired microvascular autoregulation from diabetes and cardiovascular disease. Management included antiplatelet therapy and optimization of intradialytic blood pressure, after which no further visual ischemic episodes were reported. This case highlights intradialytic hypotension as a potential nonembolic cause of CRAO in patients undergoing hemodialysis and underscores the importance of early recognition and hemodynamic optimization in this high-risk population.
proteins
2026-05-31 | Acute retinal artery occlusions.
Acute retinal artery occlusions present with sudden, painless monocular vision loss and are equivalent to cerebral strokes. The diagnosis is made on ocular fundus examination facilitated by fundus photography and optical coherence tomography. Management of acute retinal artery ischemia requires a collaborative approach among emergency department, ophthalmology, and stroke neurology providers. In the acute setting, patients should undergo a standard stroke evaluation. There are currently no widely accepted therapies for acute retinal artery occlusions. So-called "conservative treatments," such as anterior chamber paracentesis, ocular massage, and hemodilution, have no benefit and should not be pursued. Recent meta-analyses and reviews from experts have suggested a possible treatment effect for intravenous tPA within 4.5hours of vision loss or intra-arterial tPA within 6hours of vision loss for patients with acute central retinal artery occlusion. Ongoing clinical trials evaluating intravenous thrombolysis within 4.5hours of vision loss will hopefully provide definite answers. In the interim, it is essential to educate providers and patients about the importance of calling emergency services when experiencing acute vision loss to ensure immediate transfer to a facility affiliated with a stroke center, where timely diagnosis, evaluation, and treatment of acute retinal ischemia can occur.
2026-05-27 | GDF11 supplementation improved retinal structure and function in retinal ischemia injury.
Retinal ischemia is a major cause of blindness and plays a detrimental role in various diseases, including occlusion of arteries or veins, diabetic retinopathy, and ocular ischemic syndrome, which could lead to the neuronal and vascular dysfunction. As a result, maintaining their activities may help to avoid visual loss. Growth differentiation factor 11 (GDF11) has been implicated that exert neuroprotective effects and promote the angiogenesis after cerebral or cardiac ischemic injury. Here, we demonstrate that GDF11 has a protective effect on ischemia retinal injury. To simulate the morphological and functional results following retinal ischemia, a mouse unilateral common carotid artery occlusion (UCCAO) model was employed. Electroretinography (ERG) was conducted to assess the severity of retinal impairment. The effects were evaluated using hematoxylin and eosin (H&E)-staining and immunohistochemistry. In addition, angiogenic activity affected by retinal ischemia was assessed in vivo and in vitro models. We successfully established the UCCAO model and expanded the pathological understanding of UCCAO-induced retinal ischemia. The treatment with GDF11 attenuated cell death, retinal edema, gliosis and apoptosis processes in the acute phase after UCCAO. In addition, GDF11 further reduced apoptosis and improved angiogenesis in the chronic phase after UCCAO. Mechanistically, GDF11 exerted its protective effects by activating the phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT) pathway, underscoring its potential as a multifaceted therapeutic agent for retinal ischemia. Our study shows the potential of GDF11 as a novel therapeutic for recovering retinal function following retinal ischemia. The results reveal that the therapeutic benefits of GDF11 are exerted during the acute and chronic phases following retinal ischemic injury.
2026-04-21 | CD5L promotes efferocytosis and resolution of retinal ischemic injury.
Ischemia-induced retinopathy is a defining feature of prevalent ocular conditions, including diabetic retinopathy and central retinal artery or vein occlusion. Therapeutic interventions for ischemic retinopathies show limited efficacy and adverse effects, highlighting the need to thoroughly investigate the underlying mechanisms. Histone deacetylase 3 (HDAC3), a member of the histone deacetylase family, plays a central role in regulating gene expression in myeloid cells (microglia and macrophages). We recently showed that myeloid HDAC3 deletion promotes tissue repair and functional recovery after retinal ischemia-reperfusion (IR) injury via efferocytosis, a process by which myeloid cells engulf and clear apoptotic cells. Here, we investigated the mechanism by which myeloid HDAC3 deletion enhances efferocytosis. Employing an in vitro efferocytosis assay coupled with RNA sequencing on HDAC3 KO macrophages revealed that the secreted protein, CD5 molecule-like (CD5L), was the most upregulated among other pro-efferocytic genes. In vivo, we found that CD5L levels markedly increased in the retinas of myeloid HDAC3 KO mice subjected to IR injury, and its expression colocalized with myeloid cells. Co-immunoprecipitation experiments showed that HDAC3 represses CD5L expression in a liver X receptor (LXRα)-dependent manner. Additionally, we found that CD36, a receptor for CD5L that facilitates the clearance of apoptotic cells, was upregulated in retinal myeloid cells after IR. In vitro, CD5L treatment enhanced efferocytosis via CD36. We then evaluated the role of CD5L in retinal IR injury using in vivo neuronal, vascular, structural, and functional endpoints. CD5L KO mice showed worsened outcomes after IR, whereas treatment with recombinant CD5L was protective against retinal ischemic injury. Collectively, our findings suggest that deleting HDAC3 enhances macrophage efferocytosis by upregulating the CD5L/CD36 axis. CD5L may serve as a promising therapeutic target to improve outcomes in ischemic retinopathy.
2026-04-02 | Update on Acute Retinal Arterial Ischemic Disorders.
Acute retinal artery occlusions present with sudden painless monocular vision loss and are homologous to cerebral ischemic strokes. The diagnosis is made on ocular fundus examination facilitated by fundus photography and optical coherence tomography. In the acute setting, patients should undergo a standard stroke evaluation, in addition to workup for possible giant cell arteritis in patients aged 50 years and older. Recent meta-analyses of observational studies have suggested a potential positive treatment effect for intravenous tPA when delivered within 4.5 hours of symptom onset. Analyses of clinical trials evaluating intravenous thrombolysis within 4.5 hours of vision loss are ongoing.
2025-10-16 | Visual outcome comparison of intravenous thrombolysis after central retinal artery occlusions.
Central retinal artery occlusions (CRAOs) are an important cause of vision loss that lacks standardized emergent treatment. While intravenous thrombolysis is effective in acute ischemic stroke, its safety and efficacy in CRAOs remain unclear. This study compares visual outcomes of patients with CRAOs treated with intravenous thrombolysis versus medical management (MM). A retrospective cohort study was done of patients with acute CRAOs presenting with count fingers or worse. Patients receiving thrombolysis tenecteplase (TNK) or tissue plasminogen activator (tPA)] were matched to those who received MM without thrombolysis based on age, gender, hypertension, diabetes, and hyperlipidemia. Groups included 20 TNK, 19 tPA, and 39 MM patients. Primary outcomes were average visual acuity (logMAR) and proportion of patients with >20/200 vision at initial and final visit within 6 months of CRAO diagnosis. Multivariate regression controlled for demographics, comorbidities, and non-thrombolytic treatments. Better than 20/200 vision was more common in those who received TNK than MM at first follow-up [OR: 6.70, 95 % CI: (1.25, 46.4), p = 0.04]. Similarly, patients receiving TNK had significantly better average visual acuity compared to MM on the first (-0.60 logMAR difference (95 % CI: (-1.0, -0.16), p = 0.008) and final (-0.60 logMAR difference 95 % CI: (-1.1, -0.12), p = 0.01) follow-up. No symptomatic intracranial hemorrhages or intraocular hemorrhages occurred within one week following treatment. Patients who received TNK had better visual outcomes than those treated with MM, a difference that was not seen with tPA use. These findings demonstrate a possible role for TNK in the management of CRAOs.
antibodies
2026-03-27 | Comparative peripheral inflammatory biomarker profiles in central and branch retinal artery occlusion: a retrospective study.
Retinal artery occlusion (RAO), including central retinal artery occlusion (CRAO) and branch retinal artery occlusion (BRAO), is an ophthalmic emergency and an important marker of systemic vascular disease. Inflammation plays a key role in RAO pathogenesis; however, subtype-specific inflammatory profiles remain insufficiently characterized. We conducted a retrospective observational study of 363 patients diagnosed with RAO at Renmin Hospital of Wuhan University between January 2020 and April 2024 (CRAO, n = 320; BRAO, n = 43). Peripheral inflammatory biomarkers, including leukocyte count, neutrophil percentage, lymphocyte percentage, monocyte percentage, eosinophil percentage, C-reactive protein (CRP, mg/L), and neutrophil-to-lymphocyte ratio (NLR), were compared between CRAO and BRAO using independent-sample t tests or Mann-Whitney U tests, as appropriate. Sex- and age-stratified analyses were performed to explore subgroup patterns. A modest shift was observed between BRAO, CRAO patients in term leukocyte counts (6.57 ± 2.19 vs. 5.95 ± 1.66 × 10⁹/L; p = 0.03) and lymphocyte (30.75 ± 8.62% vs. 27.32 ± 7.52%; p = 0.01), but lower neutrophil percentages (58.33 ± 9.08% vs. 61.92 ± 8.07%; p = 0.01). These between-group differences were small, and group-level means largely remained within conventional reference ranges. Monocyte and eosinophil percentages did not differ significantly between groups. CRP levels (mg/L) showed no statistically significant difference, although greater variability was observed in the CRAO group. In patients with available absolute counts, BRAO demonstrated a higher NLR than CRAO. Sex- and age-stratified analyses revealed consistent subtype-related differences, with more pronounced neutrophil-lymphocyte shifts in males and steeper age-related changes in CRAO. CRAO and BRAO exhibit distinct systemic inflammatory profiles. CRAO is characterized by higher leukocyte and lymphocyte levels, suggesting broader systemic inflammatory involvement, whereas BRAO demonstrates relative neutrophil predominance and higher NLR, consistent with a more localized inflammatory response. These findings support the concept that CRAO and BRAO are immunologically distinct entities and may benefit from subtype-specific evaluation and management strategies. Prospective, multi-center studies are warranted to validate these observations and clarify their clinical implications.
2025-12-15 | Combined Treatment of Hyperbaric Oxygen and Anti-vascular Endothelial Growth Factor Therapy in Cilioretinal Artery Occlusion Associated With Central Retinal Vein Occlusion.
We report a case of a male in his early 40s who presented with transient episodes of visual blurring and was initially diagnosed with isolated cilioretinal artery occlusion (CLRAO). Hyperbaric oxygen therapy (HOT) was initiated on the same day as the onset of the preceding episode, and six sessions had been completed when he was first examined at our department. Despite ongoing HOT, he developed worsening signs of venous stasis. Further investigation confirmed CLRAO secondary to central retinal vein occlusion (CRVO) and revealed heterozygosity for the factor V Leiden mutation. HOT was continued for two weeks, and a single intravitreal injection of bevacizumab (anti-vascular endothelial growth factor (anti-VEGF)) was administered, resulting in full and sustained anatomical and functional recovery, with visual acuity improving from 8/10 to 10/10. This case supports the benefit of anti-VEGF therapy in combined CLRAO and CRVO without exudative or neovascular complications, by promoting vasoconstriction and reducing venous permeability. It also suggests a synergistic effect with HOT by further lowering retinal venous pressure through distinct mechanisms. These findings highlight the potential benefit of addressing both retinal hypoxia and venous hypertension through the combined use of HOT and anti-VEGF therapy in selected cases of mixed retinal vascular occlusion.
2025-11-11 | When vision loss signals vasculitis: central retinal artery occlusion leading to microscopic polyangiitis diagnosis-a case report.
Central retinal artery occlusion (CRAO) is an ophthalmic emergency characterized by sudden vision loss; it is rarely associated with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. Herein, we report a case of a man in his 80s who, experiencing persistent fever, weight loss, and myalgia, received corticosteroid therapy at a local hospital for a presumptive diagnosis of polymyalgia rheumatica. While on this treatment, he suddenly developed vision loss in the left eye; visual acuity was limited to light perception, and fundus examination revealed a cherry-red spot in the macula, consistent with CRAO. The patient was urgently referred and admitted to the rheumatology department of our hospital for evaluation and management of suspected systemic vasculitis underlying CRAO. The presence of persistent fever, elevated inflammatory markers, positive myeloperoxidase-ANCA, interstitial lung disease, purpura, and small-vessel vasculitis confirmed via muscle biopsy led to the diagnosis of microscopic polyangiitis. Given this clinical course and definitive diagnosis, his initial systemic symptoms were considered early manifestations of the underlying microscopic polyangiitis. The patient was treated with methylprednisolone pulse therapy and rituximab, followed by azathioprine; the inflammatory markers improved, and visual acuity recovered to hand motion by discharge. This case highlights that when CRAO occurs alongside systemic symptoms, ANCA-associated vasculitis should be strongly considered as a potential underlying cause. Timely identification of such systemic vasculitis is crucial to enhance the possibility of visual recovery and to reduce complications affecting vital organs beyond the eye.
2025-07-10 | Neovascular Proliferation over a Cosmetic Artificial Iris Implant.
The NewColorIris and BrightOcular implants were initially developed to address congenital iris defects. However, they found application for cosmetic purposes. Unfortunately, these implants are frequently linked to severe complications, including glaucoma, endothelial dysfunction, cataract development, and iris abnormalities. In this context, we present an unusual complication that manifested long after the implantation of the BrightOcular artificial iris. A 28-year-old woman presented to our emergency room with blurred vision in both eyes. She had undergone bilateral cosmetic iris implantation (BrightOcular, Stellar Devices, New York, NY, USA) 6 years earlier in Tunisia. At the first examination, her best corrected visual acuity was hand motion in the right eye and 20/100 in the left eye, and intraocular pressure (IOP) was 45 mm Hg and 30 mm Hg, respectively. Despite the maximum-tolerated glaucoma medical treatment, the elevated IOP persisted, leading to the decision to perform bilateral sequential Baerveldt glaucoma drainage device implantation. However, she subsequently developed combined central retinal artery and vein occlusion in the right eye and hypotensive maculopathy in the left eye; the latter resolving within 1 month. Two months post-surgery, extensive neovascularization above the implant of the right eye was observed, and this was successfully treated with three sequential injections of bevacizumab. Cosmetic iris implantation is associated with severe, sight-threatening complications. Herein, we describe a previously unreported case of angle neovascularization with new vessels growing over the artificial iris implant. The condition regressed after intravitreal anti-vascular endothelial growth factor injections.
2025-02-12 | Sequential central retinal artery occlusion in two brothers: a fight to prevent blindness.
Central retinal artery occlusion (CRAO) is typically associated with older patients with cardiovascular risk factors. However, its occurrence in younger patients without these risk factors suggests the need to explore rare genetic conditions. Identifying genetic disorders like adenosine deaminase 2 deficiency (DADA2), a vasculitic disease, can be critical in such cases to prevent further complications. To report the challenging diagnosis of two cases of CRAO in brothers under the age of 40, leading to the diagnosis of DADA2, a rare genetic vasculitic disorder. A 34-year-old man and his 32-year-old brother, both without significant medical histories, presented with CRAO eight years apart. Extensive diagnostic evaluations, including blood tests, imaging, and autoimmunity panels, failed to identify common causes. Progressive neurological symptoms in the older brother and the similar presentation in his sibling led to further investigation, including genetic testing. A homozygous mutation c.752C > T p.(Pro251Leu) in the CECR1 gene confirmed the diagnosis of DADA2 in both brothers. These cases underscore the importance of considering genetic disorders like DADA2 in young patients presenting with unexplained vascular occlusions. DADA2, characterized by vasculitis, immune dysregulation, and hematologic disorders, can manifest variably, complicating early diagnosis. Effective treatment with TNF inhibitors can prevent further vision loss and mitigate systemic complications. To our knowledge, these are the first reported cases of DADA2 with CRAO as the initial manifestation without prior clinical findings.
gene therapies
2026-08-10 | Combined Central Retinal Artery Occlusion, Central Retinal Vein Occlusion, and Anterior Ischemic Optic Neuropathy Following Herpes Zoster Ophthalmicus: A Case Report
International audience
2026-05-06 | Retinal Ischemic Perivascular Lesions in the Fellow Eyes of Patients with Central Retinal Artery Occlusion.
To evaluate the prevalence and characteristics of retinal ischemic perivascular lesions (RIPLs) in the clinically unaffected fellow eyes of patients with unilateral central retinal artery occlusion (CRAO) using spectral-domain optical coherence tomography (SD-OCT). This retrospective case-control study included 39 fellow eyes of patients with CRAO and 57 age-, sex-, and hypertension-matched healthy controls. Macular SD-OCT scans were assessed for the presence, number, and morphology of RIPLs, classified as narrow (<300 µm, peaked apex) or wide (>300 µm, flattened apex). Between-group comparisons were performed using appropriate parametric/non-parametric tests, and odds ratios (ORs) were calculated for RIPL presence. RIPLs were detected in 29/39 eyes (74.4%) in the CRAO fellow-eye group and 14/57 eyes (24.6%) in controls (p < 0.001). The mean number of lesions per eye was significantly higher in the CRAO group (1.36 ± 1.22) than in controls (0.35 ± 0.73; p < 0.001). Among CRAO fellow eyes with RIPLs, 5 eyes (17.2%) showed wide-type lesions, whereas all lesions in controls were narrow. The odds of RIPL presence were higher in the CRAO group (OR 8.12, 95% CI 3.20-20.57; p < 0.001). Increased RIPL burden in the fellow eyes of CRAO patients suggests that microstructural retinal changes may be detectable even in eyes without clinically evident arterial occlusion. Further longitudinal, multimodal studies are needed to determine the temporal course and underlying mechanisms.
2026-05-01 | Post-mortem fundus photographs in sudden unexpected death in infancy: An overview of the typical findings.
To show post-mortem fundus photograph (PMFP) features seen in sudden unexpected death in infancy (SUDI), to detect retinal hemorrhages, which are a crucial hallmark for abusive head trauma (AHT). Single-center, retrospective study with SUDI cases included by a French SUDI referral center in the French national registry for SUDI cases between 2017 and 2025. All available PMFP, the final diagnosis and the post-mortem interval between death and PMFP were collected. Of the 78 SUDI cases recorded in Nantes, 65 underwent a fundus examination, of which 46 had PMFP available. The mean age at death was 4.5 ± 4.9 months, 30 children were male (65%). The main PMFP features were retinal changes resembling central retinal artery occlusion and macular and/or peripheral white radial retinal folds. The presence of a macular fold was associated with a longer post-mortem interval (presence versus absence of a macular fold: 12.2 ± 7.2 h [range: 4-30] versus 4.5 ± 1.6 h [range: 3-9], p < 0.001). Retinal hemorrhages were found in four non-abusive cases with non-specific fundus features and in two confirmed AHT cases, with AHT-suggestive features. The normal post-mortem fundus in children under two years old shows a "central retinal artery occlusion" pattern, followed by the appearance of macular or peripheral white radial retinal folds, that should not be mistaken for circumferential perimacular retinal folds and hemorrhagic retinoschisis cavities that have been described in AHT cases. PMFP allow detecting and documenting retinal hemorrhages, which may be indicative of infanticide.
2026-03-24 | Risk of retinal artery occlusion in patients with primary open-angle glaucoma: a retrospective cohort study.
BACKGROUND: To evaluate the risk of Retinal Artery Occlusion (RAO) in individuals with Primary-Open Angle Glaucoma (POAG) using a large-scale real-world database. METHODS: This retrospective cohort study used the TriNetX Global Collaborative Network to analyze electronic health records from 145 healthcare organizations. Adults aged 18 years or older with POAG were compared with non-POAG controls. Propensity score matching (PSM) was performed 1:1 on 10 baseline characteristics. The primary outcome was incident RAO occurring from one day after the index POAG diagnosis up to 5 years of follow-up. Hazard ratios (HRs) were calculated using Cox proportional hazard models. Kaplan-Meier analysis was conducted to compare RAO-free survival using log-rank tests. RESULTS: After PSM, there were 260,677 patients in each cohort (50.9% female; mean age 68.2 years). POAG patients had a significantly increased risk of RAO compared with controls (3.46 vs. 1.94 per 10,000; HR 2.16; 95% CI, 1.94–2.42; p < .001). The association persisted in sex-stratified and extended follow-up analyses. Anti-glaucoma medications did not significantly alter risk. CONCLUSIONS: This large-scale cohort study identifies POAG as an independently associated risk marker for RAO. These findings highlight the importance of vascular risk assessment in POAG management and highlight the need for increased vigilance for retinal ischemic events in this population.
2026-01-24 | Ocular injuries and the most common acute conditions in ophthalmology.
Ocular traumas include a wide range of injuries from trivial conditions to extensive perforating injuries that can lead to visual function impairment of various ranges and even to the loss of the eye itself. In terms of first aid, not only an ophthalmologist but also a physician of any specialty can effectively intervene and minimize the consequences of these conditions. Open globe injuries represent prognostically the most severe conditions which have to be treated by an experienced ophthalmologist. Closed injuries are most commonly manifested as corneal erosions, foreign bodies on the surface of a globe or contusions of varying severity. These conditions do not always require urgent primary intervention by an ophthalmologist. The opposite is true for chemical traumas which are often caused by alkali. Urgent intervention consisting in eye lavage is crucial to minimize complications. Periocular tissue injuries can be divided into orbital skeletal fractures and soft tissue traumas of the orbit and eyelids. Acute conditions in ophthalmology also include inflammations of the eye and periocular tissue, of which endophthalmitis and retroseptal orbital cellulitis are the most prognostically serious. Acute retinal circulatory disorders include central retinal artery occlusion and acute ischemic optic neuropathy. Acute angle-closure crisis can be manifested as sudden severe pain of the globe, headache and blurred vision. The other most common causes of acute visual impairment are hemophtalmus and retinal detachment, the conditions which require specialized intervention of an ophthalmologist. Sudden conditions in ophthalmology require prompt diagnosis and early basic medical intervention which can be provided by a physician of any specialty and can significantly reduce subsequent complications. Ultimate treatment then belongs to the ophthalmologist.
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2026-07-12 | Reinforced double-layer vein patch angioplasty in carotid endarterectomy to mitigate patch aneurysm.
Carotid endarterectomy with patch angioplasty is standard for symptomatic carotid stenosis. However, prosthetic patches carry a risk of infection, particularly in patients with recent endocarditis. We report the case of a 67-year-old man who presented with central retinal artery occlusion and active mitral valve vegetation and subsequently underwent left carotid endarterectomy using a dual-layer facial vein patch. The harvested facial vein was everted to create a reinforced, double-layered conduit that was used for patch angioplasty, thereby avoiding prosthetic material. The patient awoke neurologically intact and 1-month duplex ultrasound demonstrated no residual stenosis or aneurysmal degeneration. Dual-layer everted cervical vein patches may provide a safe and durable autologous option in high-risk infectious settings.
2025-02-11 | Transfer of Mitochondria from Healthy Stem Cells to Injured Cells in Stroke with Retinal Impairments.
Stroke is the second leading cause of mortality worldwide, with retinal ischemia as its prominent complication. However, the pathology of retinal ischemia has not been fully elucidated, resulting in a lack of effective treatment. Stem cell therapy has been suggested to be therapeutic in retinal ischemia, with mitochondrial transfer potentially one of the underlying mechanisms. To investigate the mitochondrial function in retinal ischemia and the potential of mitochondrial transfer from mesenchymal stem cells (MSCs), in vivo middle cerebral artery occlusion (MCAO) model and in vitro oxygen-glucose deprivation (OGD) model were utilized in combination. In vivo, rats subjected to MCAO were randomly administered intravenous MSCs or vehicles. Laser doppler was used to measure the blood flow in the brain and the eye, along with immunohistochemical staining for assessing cellular degeneration. In vitro, retinal pigment epithelium (RPE) cells exposed to OGD were cocultured with or without MSCs. Mitochondrial function was measured by mitochondrial respiration, mitochondrial network analysis, mitochondria live cell imaging, and immunocytochemistry. The results demonstrated improved cell survival and restored mitochondrial function following MSC therapy. This chapter details the protocols necessary to produce the in vivo and in vitro models of ischemic stroke along with an assessment of mitochondrial function. Elucidating the mechanisms of mitochondrial transfer will further the knowledge in regenerative medicine and may enable new targets of therapeutics for stroke, especially for retinal ischemia.
2022-08-28 | Major clinical findings of cellular therapy for intravitreal use in ischemic retinopathy and macular degeneration: a systematic review
Introduction: In the scenario of eye diseases, diabetic retinopathy and retinal vein occlusion are the two most common ischemic retinopathies in the world. Ischemia is caused by retinal vascular diseases due to decreased blood perfusion and the appearance of areas of retinal non-perfusion. Also, age-related macular degeneration (AMD) is the most common cause of irreversible vision loss in people over 65 years of age in industrialized countries. By 2020, around 200 million people will be affected by AMD worldwide. Objective: the present systematic review study aimed to highlight the main clinical findings of the treatment of ischemic retinopathy and age-related macular degeneration through cell therapy with bone marrow stem cells. Methods: The rules of the Systematic Review-PRISMA Platform were followed. The search was carried out from March 2022 to June 2022 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument. The risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: It was found 235 articles involving retinitis pigmentosa, macular degeneration, and bone marrow stem cell therapy. A total of 51 were fully evaluated and 28 studies were included and developed in a systematic review in the results field. The symmetrical Funnel Plot does not suggest a risk of bias between the small sample size studies. It was concluded that intravitreal injection of bone marrow-derived stem cells in a patient with retinal vascular occlusion sequelae demonstrated that the procedure is feasible and safe to be performed in humans as there were no signs of infection, inflammation, or development of intraocular tumor formation. Also, neurotrophic effects correlate with vasculature preservation, suggesting that bone marrow-derived stem cells can be used in the treatment of diseases such as retinal degenerations and vasculopathy that currently lack effective treatment. The authors concluded that stem cells can protect retinal cells from degeneration and also suggested that they were able to replace some types of lost retinal neurons.
2022-03-24 | Oxidative stress facilitates exogenous mitochondria internalization and survival in retinal ganglion precursor-like cells
Ocular cells are highly dependent on mitochondrial function due to their high demand of energy supply and their constant exposure to oxidative stress. Indeed, mitochondrial dysfunction is highly implicated in various acute, chronic, and genetic disorders of the visual system. It has recently been shown that mitochondrial transplantation (MitoPlant) temporarily protects retinal ganglion cells (RGCs) from cell death during ocular ischemia. Here, we characterized MitoPlant dynamics in retinal ganglion precursor-like cells, in steady state and under oxidative stress. We developed a new method for detection of transplanted mitochondria using qPCR, based on a difference in the mtDNA sequence of C57BL/6 and BALB/c mouse strains. Using this approach, we show internalization of exogenous mitochondria already three hours after transplantation, and a decline in mitochondrial content after twenty four hours. Interestingly, exposure of target cells to moderate oxidative stress prior to MitoPlant dramatically enhanced mitochondrial uptake and extended the survival of mitochondria in recipient cells by more than three fold. Understanding the factors that regulate the exogenous mitochondrial uptake and their survival may promote the application of MitoPlant for treatment of chronic and genetic mitochondrial diseases.
2022-02-17 | Histological Assessment of Rat Retinas with Ischemia-Reperfusion Injury.
Retinal ischemia-reperfusion (IR) injury occurs in pathological situations that interrupt the blood flow to the retina, such as is the case during central retinal artery occlusion (CRAO). The animal models described in the literature are based on the pressure produced by the weight of a given quantity of saline elevated to a certain height; however, to establish these parameters it is necessary to perform mathematical calculations that cannot be easily redone in the case of punctual variations of intraocular pressure (IOP). The aim of this study was to present a new system that allows us to reproduce the conditions of retinal IR and thereby properly assess the level of injury in retinal histological samples. We developed a retinal IR model in WAG/RijHsd rats based on CRAO through increasing IOP. To develop this model, we produced ischemia for 1 h using a hydrostatic pressure system that maintained a constant high IOP and then allowed reperfusion for 1 h. The injury attributable to IR was assessed by histological examination of retinal samples, determining whether there was histological damage and/or dendritic swelling and counting the outer nuclear layer cells showing cytoplasmic swelling. The increase in IOP to 150 mm Hg produced CRAO, in turn causing observable histological damage and dendritic swelling in all retinas subjected to IR. Counting the number of cells showing cytoplasmic swelling yielded a mean of 102.5 ± 35 cells/field. The contralateral retinas were healthy, showing no significant changes. The retinal IR model proposed is simple, reproducible, and allows variable durations of ischemia and reperfusion, and most importantly, it allows easy correction by adjusting the pressure of the sphygmomanometer, of any change in IOP to keep the ischemia stable, without having to recalculate the elevation height of the ischemia induction system. Moreover, the damage caused by IR can be effectively assessed by the type of histopathological assessment performed. For these reasons, it can be considered a reliable method for studying drugs that may prevent retinal IR injury.
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Drug Discovery Landscape
2 orphan drug designations for Central retinal artery occlusion.
2 orphan drug designations for Central retinal artery occlusion.
Drug | Therapy type | Regulator | Orphan designation | Approval | Sponsor |
|---|---|---|---|---|---|
Sodium 4-amino-3- [6-( 4-fluoro-2-methylphenyl)pyridine-3-ylazo] naphthalene-1-sulfonate dihydrate | small molecules | FDA | 2022-05-03 | — | Kyoto Drug Discovery & Development Co., Ltd. |
mesencephalic, astrocyte-derived neurotrophic factor | proteins | FDA | 2015-09-10 | — | Amarantus BioScience Holdings, Inc. |
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