Presence of Embolic Source and Outcome in Central Retinal Artery Occlusion

Objectives: The etiology of central retinal artery occlusion (CRAO) is unclear in approximately 50% of patients, suggesting pathomechanical heterogeneity; moreover, little is known about outcomes according to etiology. This study investigated whether the presence of an embolic source affects outcome in CRAO.

Methods: CRAO patients within 7 days of symptom onset were retrospectively enrolled. Clinical parameters, including initial and 1-month visual acuity, CRAO subtype, and brain images, were reviewed. CRAO etiology was categorized as CRAO with or without an embolic source (CRAO-E and CRAO-E). Visual improvement was defined as a decrease in logarithm of the minimum angle of resolution ≥0.3 at 1 month.

Results: A total of 114 patients with CRAO were included. Visual improvement was noted in 40.4% of patients. Embolic sources were identified in 55.3% of patients, and visual improvement group rather than no improvement group was more commonly associated with the presence of an embolic source. In multivariable logistic regression analysis, CRAO-E independently predicted visual improvement (odds ratio 3.00, 95% CI 1.15-7.81, = 0.025).

Discussion: CRAO-E was found to be associated with a better outcome. CRAO-E may be more prone to recanalization than that CRAO-E.