Central Retinal Artery Occlusion

Question 1

What causes a central retinal artery occlusion and how does it present?

Answer 1

• Due to a carotid atheroma (in setting of HTN) or left atrial mural thrombus (in setting of atrial fibrillation)
  that’s launched off to the retinal vessels.

Presented as sudden, painless, unilateral blindness, with “curtain comes down.”

Question 2

What is a key clinical sign of central retinal artery occlusion?

Answer 2

Cherry red-spot on fovea
(pale retina will be seen on fundoscopy with a cherry red spot due to maintenance of perfusion from the
choroidal artery)

Also, USMLE can show image weird crescent-shaped
finding is called a “refractile body,” and refers to an embolus.

Question 3

What is amaurosis fugax in relation to central retinal artery occlusion?

Answer 3

A transient occlusion that can occur

Question 4

What are the initial treatments for central retinal artery occlusion?

Answer 4

• Ocular massage
• High flow oxygen

Question 5

What is the time frame for thrombolysis treatment in central retinal artery occlusion?

Answer 5

Within 8 hours