Central Retinal Artery Occlusion

Question 1

Answer 1

Central retinal artery occlusion

Question 2

Central retinal arterial occlusion

Answer 2

Medical emergency caused by central retinal artery obstruction

Rare form of occular stroke

Question 3

Aetiology of central retinal artery occlusion

Answer 3

• carotid artery atherosclerosis (80% cases)
• giant cell arteritis (or other vasculitide)

Question 3

Risk factors for central retinal arterial occlusion

Answer 3

cardiovascular disease risk:
- smoking
- hypertension
- diabetes
- hyperlipidaemia

Giant cell arteritis risk:
- white ethnicity
- increased age
- female
- polymyalgia rheumatica

Question 4

Clinical features of central retinal arterial occlusion

Answer 4

• suddent painless loss of vision
• monocular
• severly reduced VA
• ‘curtain coming down’

Question 5

Examination findings in central retinal arterial occlusion

Answer 5

Fundoscopy:
- pale retina
- cherry red spot

Relative afferent pupillary defect

Question 6

Differentials for central retinal arterial occlusion

Answer 6

painless loss of vision:
- retinal detachment
- central retinal veinous occlusion
- vitreous haemmorhage

Question 7

Managing central retinal arterial occlusion

Answer 7

Aim is to dissolve/dislodge clot

Reperfusion:
- occular massage

Reduce intraocular pressure:
- acetazolamide, timolol, mannitol
- anterior chamber parocentesis

Vasodilation:
- inhaled carbogen
- sublingual isosorbide dinitrate