Retinal Vein Occlusion and Artery Flashcards
How does RVO present?
Painless sudden vision loss
What does RVO cause?
Neovascularisation
Macular oedema
Retinal haemorrhages
What are RFs for RVO?
HTN Cholestrol DM Smoking Glaucoma SLE
What is seen on fundoscopy for RVO?
FLame and blot haemorrhages
Optic disc oedema
Macular oedema
How is RVO managed?
Bloods for comorbidities
Laser photocoagulation
Dexamethasone intravitreously
AntivEGF Ranibizuman
What blood vessels supply the retinal artery?
Opthalmic > Internal Carotid
What is most common cause of RA occulusion
Atheroschlerosis
Or
GCA
Vasculitis
Risk factos for RAO?
Age FH Smoking HTN Alcohol DM Diet Inactivity Obesity or GCA- polymyalgia rheumatica & female over 50
How does RAO present?
Sudden painless vision loss
Relative afferent pupil defect (light shone in other eye causes affected one to contrict more)
What does fundoscopy show in RAO?
Pale retina with cherry red spot
How is RAO managed?
Urgent opthalmology review
if GCA- ESR and artery biospy needed then high dose steroids
If not-
Occular massage, remove fluid from ant chamber to reduce pressure
Inhaled carbogen to dilate artery (CO2 and O2)
Sublingual isosorbide dinitrate to dilate artery
Long term needs risk factors adjusting.
What are the Keith Wagener stages of hypertenisve retinopathy?
Stage Features I Arteriolar narrowing and tortuosity Increased light reflex - silver wiring II Arteriovenous nipping III Cotton-wool exudates Flame and blot haemorrhages IV Papilloedema
