Central retinal artery occlusion Flashcards
Pathophysiology of central retinal artery occlusion
Where something blocks the flow of blood through the central retinal artery
Purpose of the central retinal artery
Supplies blood to the retina
What artery does the central retinal artery come from
Branch of the ophthalmic artery, which is a branch of the internal carotid artery
Causes of central retinal artery occlusion
Atherosclerosis - most common
Giant cell arteritis
How does giant cell arteritis cause central retinal artery occlusion
Vasculitis affecting the ophthalmic or central retinal artery causes reduced blood flow
Risk factors for central retinal artery occlusion
Increased risk of atherosclerosis:
Older age Family history Smoking Alcohol consumption Hypertension Diabetes Poor diet Inactivity Obesity
Increased risk of GCA: White 50+ yo Females Polymyalgia rheumatica
Presentation of central retinal artery occlusion
Sudden painless loss of vision
Relative afferent pupillary defect
Relative afferent pupillary defect
Pupil in the affected eye constricts more when light is shone in the other eye compared when it is shone in the affected eye.
Presentation on fundoscopy
Pale retina
Cherry red spot
Management of central retinal artery occlusion
Immediate referral
GCA - high dose steroids -prednisolone 60mg
Long term management:
- treating reversible RFs and secondary prevention of cardiovascular disease
Investigations for central retinal artery occlusion
Test for GCA - CRP and temporal artery biopsy
Immediate management of central retinal artery occlusion
- Ocular massage
- Removing fluid from the anterior chamber to reduce intraocular pressure.
- Inhaling carbogen (a mixture of 5% carbon dioxide and 95% oxygen) to dilate the artery
- Sublingual isosorbide dinitrate to dilate the artery
