occlusion

Question 1

what is CRAO?

Answer 1

Central retinal artery occlusion is a relatively rare cause of sudden unilateral visual loss. It is due to thromboembolism (from atherosclerosis) or arteritis (e.g. temporal arteritis)

Question 2

features of CRAO?

Answer 2

sudden, painless unilateral visual loss
relative afferent pupillary defect
‘cherry red’ spot on a pale retina

Question 3

what is this?

Answer 3

CRAO

Question 4

mx of CRAO?

Answer 4

any underlying conditions should be identified and treated (e.g. intravenous steroids for temporal arteritis)
if a patient presents acutely then Intraarterial thrombolysis may be attempted but currently, trials show mixed results.

Question 5

what is CRVO?

Answer 5

Central retinal vein occlusion (CRVO) is a differential for sudden painless loss of vision.

Question 6

RF of CRVO?

Answer 6

increasing age
hypertension
cardiovascular disease
glaucoma
polycythaemia

Question 7

features of CRVO?

Answer 7

sudden, painless reduction or loss of visual acuity, usually unilaterally
fundoscopy
widespread hyperaemia
severe retinal haemorrhages - ‘stormy sunset’

Question 8

what is BRVO?

Answer 8

A key differential is branch retinal vein occlusion (BRVO) - this occurs when a vein in the distal retinal venous system is occluded and is thought to occur due to blockage of retinal veins at arteriovenous crossings. It results in a more limited area of the fundus being affected.

Question 9

what is mx of CRVO?

Answer 9

the majority of patients are managed conservatively
indications for treatment in patients with CRVO include:
macular oedema - intravitreal anti-vascular endothelial growth factor (VEGF) agents
retinal neovascularization - laser photocoagulation