Retinal Occlusions Flashcards
What is the central retinal artery
Supplies blood to retina. Branch of ophthalmic artery which is branch of internal carotid
Most common cause of central artery occlusion
atherosclerosis, giant cell arteritis (vasculitis affecting ophthalmic or central retinal artery causes reduced blood flow)
Sources of central retinal artery occlusion
Carotid or cardiac
Risk factors for retinal artery occlusion
Older age, FHx, smoking, alcohol, HTN, diabetes, poor diet, inactivity, obesity
Symptoms of retinal artery occlusion
Sudden painless loss of vision, relative afferent pupillary defect, pale retina with cherry red spot
Management of retinal artery occlusion
Test for giant cell arteritis (ESR and temporal artery biopsy), high dose steroids (60-80mg prednisolone), treat reversible risk factors
What makes up the central retinal vein
4 branched veins which come together to form the central retinal vein. Runs through optic nerve and drains blood from retina
What happens if one of the retinal vein branches are blocked
Causes problems in that area drained by the vein, which causes pooling of blood in the retina
Symptoms of retinal vein occlusion
Sudden painless loss of vision, flame and blot haemorrhages, optic disc oedema, macula oedema, neovascularisation
Risk factors of retinal vein occlusion
HTN, high cholesterol, diabetes, smoking, glaucoma, systemic inflammatory conditions (SLE)
Other tests to conduct in retinal vein occlusion
Full medical history to look for underlying systemic disease, FBC leukaemia, ESR for inflammatory disorders, BP for hypertension, serum glucose for diabetes, plasma protein electrophoresis
What to check for if patient presents who is <50 years old
Homocystein, consider coagulation disorder (lupus)
Things to check for in arterial vein occlusion
Giant cell arteritis and ESR
Features of giant cell arteritis
Sudden irreversible blindness, >50 years old, headache, scalp/temporal tenderness, jaw claudication
What does GCA immediately need
Treatment with high dose steroids
