The idling retina: reversible visual loss in central retinal artery obstruction.
Based on experimental studies, sustained total central retinal artery obstruction (CRAO) lasting more than one and one-half hours has been considered to cause irreversible retinal damage. We have seen five cases of patients with pure CRAO that lasted longer than one and one-half hours who regained significant visual acuity. Three of the patients had a completely spontaneous improvement in visual acuity to 20/50 or better. In addition, the other two patients regained significant vision to 20/80 or better with a modified treatment regimen of acetazolamide, inhalation of 5% CO2 and 95% O2, and aspirin. No foveola-sparing cilioretinal arteries were present in any of the cases. We introduce the concept of reversible retinal ischemia following unsustained CRAO to account for these unexpected improvements in visual acuity.
D000086:Acetazolamide / Q000627:therapeutic use; D000368:Aged; D001241:Aspirin / Q000627:therapeutic use; D004176:Dipyridamole / Q000627:therapeutic use; D006801:Humans; D008297:Male; D012161:Retinal Artery; D012164:Retinal Diseases / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy; D014785:Vision, Ocular
D004176:Dipyridamole; D000086:Acetazolamide; D001241:Aspirin