Central retinal artery occlusion: Research & Drug Discovery Data

Drug discovery

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].

Population

Predominantly affects adults aged 50–80 years, with higher incidence in males [6][10].
Key risk factors: hypertension (58–68%), diabetes (23–34%), hyperlipidemia (47–59%), smoking, and carotid artery disease [2][6][9].

Burden

80% develop permanent vision loss ≤20/400; 15–20% develop neovascular complications [5][8][11].
5% risk of stroke within 2 weeks; mortality rate 2.5× higher than age-matched controls [4][10][13].
Annual incidence: 1.8–2.5 cases per 100,000, rising to 10/100,000 in those >80 years [6][9][13].

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

732 drug discovery papers related to Central retinal artery occlusion, with 3 first-in-class and 3 next-in-class early-stage therapies forecasted to outperform the average preclinical success rate. Recent publications:

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.

Open article ↗

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.

Open article ↗

2026-07-06 | Correction: Correction: Intravenous thrombolysis for acute central retinal artery occlusion: Protocol for a systematic review and individual participant data meta-analysis of randomized controlled trials.

[This corrects the article DOI: 10.1371/journal.pone.0351934.].

Open article ↗

2026-07-12 | Reinforced double-layer vein patch angioplasty in carotid endarterectomy to mitigate patch aneurysm.

Open article ↗

2026-07-07 | Central Retinal Artery Occlusion Following Intradialytic Hypotension in End-Stage Renal Disease

Open article ↗

2026-07-06 | Correction: Correction: Intravenous thrombolysis for acute central retinal artery occlusion: Protocol for a systematic review and individual participant data meta-analysis of randomized controlled trials.

[This corrects the article DOI: 10.1371/journal.pone.0351934.].

Open article ↗

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Drug Discovery Landscape

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.

Central retinal artery occlusion

Central retinal artery occlusion

Central retinal artery occlusion

Overview

Population

Burden

Therapies

Categories: rare ophthalmic disorders

Research Papers

2026-07-12 | Reinforced double-layer vein patch angioplasty in carotid endarterectomy to mitigate patch aneurysm.

2026-07-07 | Central Retinal Artery Occlusion Following Intradialytic Hypotension in End-Stage Renal Disease

2026-07-06 | Correction: Correction: Intravenous thrombolysis for acute central retinal artery occlusion: Protocol for a systematic review and individual participant data meta-analysis of randomized controlled trials.

2026-07-12 | Reinforced double-layer vein patch angioplasty in carotid endarterectomy to mitigate patch aneurysm.

2026-07-07 | Central Retinal Artery Occlusion Following Intradialytic Hypotension in End-Stage Renal Disease

2026-07-06 | Correction: Correction: Intravenous thrombolysis for acute central retinal artery occlusion: Protocol for a systematic review and individual participant data meta-analysis of randomized controlled trials.

Drug Discovery Landscape

Updated: Aug 16, 2026