Branch Retinal Artery Occlusion (BRAO) Treatment & Management

Updated: Feb 15, 2023
  • Author: Rishabh C Date, MD; Chief Editor: Hampton Roy, Sr, MD  more...
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Treatment

Medical Care

Considering the increased rate of mortality, patients with branch retinal artery occlusion (BRAO) should receive a full medical workup with special attention to the cerebrovascular and cardiovascular system. Depending on the findings, carotid endarterectomy or anticoagulation may be indicated. Laboratory workup for coagulopathies should be performed if no embolic source is found.

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Surgical Care

Surgical embolus excision has been described in a few case reports, with the authors reporting good visual outcome and safety. [32, 33] Given the natural history of frequent spontaneous visual improvement and generally good visual outcome in untreated BRAO, further investigation with a randomized controlled trial likely is needed to validate surgical embolus excision as a treatment option in BRAO.

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Consultations

Refer to an internist for complete systemic workup.

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Prevention

Controlling blood pressure, cholesterol, and diabetes can greatly reduce the risk for atherosclerotic disease.

Smoking cessation can lower the risk for stroke.

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Long-Term Monitoring

Patients initially should be evaluated every 3-6 months to monitor progression.

Ocular neovascularization after BRAO is rare. If neovascularization occurs, panretinal photocoagulation should be performed.

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