Clinical Guidelines for the Diagnosis and Management of Retinal Artery Occlusions by the Spanish Society of Retina and Vitreous (SERV)

Retinal arterial occlusions (RAOs) constitute a rare but serious ophthalmological emergency with a poor prognosis for visual recovery, for which there is currently no adequate therapeutic strategy. However, there is substantial evidence highlighting the importance of systemic (non-ophthalmological) management of patients with RAO. Since RAOs are the ocular analogous of a cerebral stroke, they require a similar urgent, multidisciplinary approach involving laboratory tests and imaging studies that go beyond the typical scope of ophthalmologists. This calls for cooperation and understanding from all stakeholders, including neurologists, radiologists, interventional neuroradiologists, emergency and primary care physicians, as well as patients and the wider community. Therefore, while there are presently no proven therapies to restore vision following RAOs, the ophthalmologist's primary responsibility lies in prompt systemic referral. It is imperative to exclude underlying vascular pathology to rule out concurrent cerebrovascular disease and to minimize the risk of subsequent cerebrovascular and cardiovascular events. These guidelines have been developed by a panel of retina specialists in Spain, representing the Spanish Retina and Vitreous Society (SERV). The recommendations provided are derived from an evidence-based expert consensus methodology and not from a formal systematic review. The aim is to inform ophthalmologists and other healthcare professionals who care for these patients about the significance and seriousness of the condition, support decision-making regarding appropriate ophthalmological and systemic management, and provide a foundation for creating protocols.