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Ophthalmology > 3: Central Retinal Artery and Vein Occlusion > Flashcards

3: Central Retinal Artery and Vein Occlusion Flashcards

1
Q

Define central retinal artery occlusion

A

Occlusion of the central retinal artery

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2
Q

Describe anatomy of central retinal artery

A

First branch of the ophthalmic artery

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3
Q

What is more common central retinal artery or vein occlusion

A

Central retinal vein occlusion

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4
Q

What are the 3 causes of central retinal artery occlusion

A
  • Embolic
  • Thrombotic from carotid.a
  • Vasculitis
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5
Q

What are 2 causes of embolic central retinal artery occlusion

A

AF

Thrombosis from carotid.a atherosclerosis

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6
Q

What are risk factors for central retinal artery occlusion

A

Male
Age

Cardiovascular risk - CVD, Obesity, Diabetes, Smoking, HTN.

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7
Q

How does central retinal artery occlusion present

A

Sudden-onset decrease in visual acuity to less than 90%

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8
Q

What will be seen in central retinal artery occlusion

A

Relevant afferent pupillary defect

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9
Q

What is a transient central retinal artery occlusion also known as

A

Amaurosis fugax

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10
Q

Define amaurosis fugax

A

Sudden painless vision loss lasting seconds-minutes followed by spontaneous recovery

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11
Q

If a carotid bruit is present in central retinal artery occlusion what does it mean

A

Carotid artery stenosis

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12
Q

If irregular pulse is present in central retinal artery occlusion what may it indicate

A

AF

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13
Q

If scalp tenderness is present in central retinal artery occlusion what may it indicate

A

GCA

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14
Q

How often should someone be seen if they have sudden visual loss

A

within 6h

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15
Q

What is an approach to sudden visual loss

A

HEELP

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16
Q

What does HEELP refer to

A

H = headache

E = eye movements painful

E = ESR raised

L = lights or flashes preceding

P = poorly controlled diabetes - vitreous haemorrhage

17
Q

What does raised ESR indicate

A

GCA

18
Q

What does painful eye movements indicate

A

Optic neuritis

19
Q

What does lights or flashing indicate

A

Retinal detachment

20
Q

What may poorly controlled diabetes indicate

A

Vitreous haemorrhage

21
Q

What is seen on ophthalmoscopy in central retinal artery occlusion

A

Pale retina with cherry red spot

22
Q

explain cherry-red spot at the fovea centralists

A

There are no nerve fibres at avascular zone - therefore it is not affected by oedema of the vascular layer and can be seen as red against whit background

23
Q

what is the aim of treatment in central retinal artery occlusion

A

increase blood flow

24
Q

what are methods to increase intra-ocular blood flow

A

ocular massage
surgical removal aqueous
intra-ocular HTN Rx

25
Q

what is the problem with central retinal artery occlusion

A
  • Causes retinal ischaemia
  • This stimulates VEGF
    secretion
  • Neovascularisation increases risk of vitreous haemorrhage and subsequent retinal detachment
26
Q

What is central retinal vein occlusion

A

occlusion of central retinal vein

27
Q

In which age group does central retinal vein occlusion occur

A

> 60

28
Q

What are 5 causes of central retinal vein occlusion

A 
Atherosclerosis 
HTN 
Hypercoagulable state 
Diabetes 
Glaucoma
29
Q

What are 3 hyper coagulable stages

A

COCP
Polycythaemia
Sickle cell

30
Q

How does central retinal vein occlusion present clinically

A

Sudden painless visual loss

31
Q

How does central retinal vein occlusion present on fundoscopy

A

flame-shaped haemorrhages in all 4-quadrants giving a stormy sky appearance

32
Q

How quickly should central vein occlusion be referred

A

same-day ophthalmology referral

33
Q

if visual loss has occurred, what is used to manage central retinal vein occlusion

A
  1. anti-VEGF
  2. Dexamethasone
  3. Photocoagulation
34
Q

what is complication of central retinal vein occlusion

A

ischaemia leads to neovascularisation = increases risk of vitreous haemorrhage

Ophthalmology (12 decks)

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