What is the recommended treatment for central retinal artery occlusion secondary to temporal arteritis?

Central retinal artery occlusion (CRAO) associated with temporal arteritis (giant cell arteritis) is a serious condition that requires immediate intervention. Temporal arteritis is characterized by inflammation of the large blood vessels and can lead to significant visual impairment due to occlusion of the central retinal artery.

The recommended treatment for CRAO secondary to temporal arteritis is high-dose corticosteroids, such as methylprednisolone. The rationale behind this treatment lies in the need to reduce inflammation and prevent further vascular complications that could result from the underlying systemic condition. Corticosteroids can help restore blood flow and protect against irreversible vision loss that often accompanies temporal arteritis, especially as it can lead to permanent damage to the optic nerve if not treated promptly.

Other treatment options are less appropriate in this scenario. Acetazolamide aids in reducing intraocular pressure but does not address the inflammation or the occlusive event itself. Phenylephrine eye drops are used primarily to dilate the pupil or manage certain conditions related to the eye but do not treat the underlying occlusion. Topical antibiotics have no role in this acute setting as this condition is not caused by an infection but rather by vascular inflammation.

Therefore, administering methylprednisolone provides the most effective approach to