Central retinal artery occlusion

Question 1

Presentation?

Answer 1

acute, painless monocular vision loss, persists for several hours.

Question 2

causes?

Answer 2

embolized plaque from ipsilateral carotid artery, cardioembolic source (atrial feb).

Question 3

Can develop?

Answer 3

significant permanent visual deficits.

Question 4

On fundoscopy?

Answer 4

whitened retina due to edema, macula (central fovea appears red from underlying choroid ‘’ cherry red spots’’.

Question 5

pt have a defect?

Answer 5

usually a defect in the afferent pupil reflex.

Question 6

ER?

Answer 6

recovering vision ( anterior chamber paracentesis, ocular massage, revascularization).

Question 7

workup includes?

Answer 7

noninvasive imaging of the carotids to evaluate stenosis.

Question 8

atherosclerotic tx?

Answer 8

aspirin, statin

Question 9

in case of cardioembolic

Answer 9

long term anticoagulation (ex: warfarin).

Question 10

Hypertensive retinopathy

Answer 10

does not have acute vision loss, on fundoscopy (focal spasm of arterioles followed by sclerosis and narrowing).

Question 11

retinal detachment

Answer 11

have light flashes, floaters, or a curtain across their visual field( usually starting from the periphery rather than dropping vertically) that is not transient. fundoscopy reveals a wrinkled or detached retina.

Question 12

viterous hemorrhage

Answer 12

due to retinal tear, viterous detachment. Diabetic retinopathy is a common cause.
pt have floaters.
on fundoscopy, hemorrhage is seen.