Retina becomes diffusely pale within hours of the onset of occlusion, with the exception of the fovea, which retains a reddish hue. Fluorescein angiography reveals choroidal filling and ciliary branches perfusing the optic nerve head while displaying delayed retinal arterial filling with a prolongation of the arteriovenous circulation time. Ten percent may retain central visual acuity because of the presence of patent cilioretinal artery perfusing the fovea. After several weeks, acute retinal opacification fades and circulation is restored. Narrowed arteries and RAPD persist.
Optic atrophy develops with time.
Treatment One of the true ophthalmologic emergencies. Although most patients present for evaluation after this critical period, treatment should be attempted during the first 24 hours. Prompted by the general ineffectiveness of these therapies, other therapeutic interventions have been attempted. Review of Selective Intra-arterial Fibrinolysis Weber, J. et al. Selective Intra-Arterial Fibrinolysis of Acute Central Retinal Artery Occlusion.