Retinal artery occlusion


Usually presents as painless monocular vision loss.

The central retinal artery and its branches perfuse the inner retina.

Commonly caused by embolism of the retinal artery.

Central retinal artery occlusion incidence estimated 1-2 per hundred thousand people per year

Emboli can travel to the most distal branches of the retinal artery with partial loss of the visual field.

Sources of retinal emboli include cholesterol plaque associated with atherosclerosis, platelet fibrin emboli associated with cardioembolism or disorders of arterial hypercoagulability, and calcific plaque associated with cardiac valvular disease.

Ophthalmologic emergency.

Visual acuity in affected eye can occur with 80% of patients having a final visual acuity of 20/400 or worse.

Any delay in treatment can result in permanent visual loss.

Immediate treatment improves chances of retaining vision but only 21-35% of individuals maintain adequate vision.

Harbinger of other systemic processes.

Associated with an increased risk of stroke.

Symptomatic stroke, TIA or amarorosis fugax, is common around the time of a central retinal arterial occlusion and requires urgent embolic work up.

The retina is supplied with blood flow from the ophthalmic artery which is the first intracranial branch of the internal carotid artery.

The central retinal artery supplies the retina.

The ciliary arteries supply the choroid and the anterior globe.

Fundoscopic exam reveals a pale retina and a red macula.

May be due to embolism, atherosclerosis changes, inflammation, angiospasm or hydrostatic occlusion.

Complete occlusion is rare.

Central retinal artery affected 57% of cases, the branch retinal artery 38% of cases and the cilioretinal artery in 5% of obstructions.

Occlusion of the central retinal artery is characterized by diffuse retinal whitening with a macular ch2242y red spot.

Branch retinal artery occlusion affects the region of the retina and causes the inner layers of the retina which are normally transparent to become edematous and semiopaque obscuring the pigment epithelium and causing a whitening visible on funduscopic examination.

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