Central Retinal Artery/Vein Occlusion

Question 1

How does central retinal artery/vein occlusion present?

Answer 1

Sudden, painless, monocular, profound vision loss

Like a curtain/shutter across vision (over seconds)

Question 2

What is central retinal artery occlusion (CRAO) commonly due to?

Answer 2

Usually due to embolus from carotids/heart (ie. like a stroke)

Question 3

What does transient central retinal artery occlusion commonly cause?

What are its clinical features?

Answer 3

Transient CRAO → retinal TIA → amaurosis fugax

Vision lost in seconds, recovers in mins

Question 4

Signs in central retinal artery occlusion

Answer 4

RAPD and pale retina in affected eye

Question 5

What is the treatment for CRAO?

Answer 5

No proven treatment

Several anecdotal treatments eg. breathing into paper bag

Work up in TIA/stroke clinic (carotid dopplers, echo)

Question 6

What is CRVO (central retinal vein occlusion) mostly due to?

Answer 6

• Local thrombosis
• Associated w/hypertension, DM, hypercoagulability, >60s

Question 7

What clinical signs on fundoscopy suggest CRVO?

Answer 7

• multiple disc + retinal haemorrhages
• macular oedema

Question 8

How is CRVO treated?

Answer 8

Anti-VEGF

Retinal laser