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)
• transient CRAO → retinal TIA → amaurosis fugax
  
  • vision lost in seconds, recovers in mins

Question 3

What signs can be examined for in CRAO?

Answer 3

• RAPD
• pale retina

Both in affected eye

NB: think of GCA if over 60

Question 4

What is the treatment for CRAO?

Answer 4

• no proven treatment
• several anecdotal treatments eg. breathing into paper bag
• work up in TIA/stroke clinic (carotid dopplers, echo)

Question 5

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

Answer 5

• local thrombosis
• associated w/
  
  • hypertension
  • diabetes mellitus
  • hypercoagulability
  • over 60s

Question 6

What clinical signs on fundoscopy suggest CRVO?

Answer 6

• multiple disc + retinal haemorrhages
• macular oedema

Question 7

How is CRVO treated?

Answer 7

• anti VEGF
• retinal laser