vascular disease of the eye Flashcards
what is retinal artery occlusion
blockage of one of the retinal arteries
what is the most common cause of retinal artery occlusion
atherosclerosis-related thrombosis
what are the 3 main types of retinal artery occlusion
central artery, branch artery, amaurosis fugax
what is amaurosis fugax
transient central retinal artery occlusion
how long does amaurosis fugax last
5 mins with full recovery
what would a patient describe the vision loss like in amaurosis fugax
like a curtain coming down
main symptom of amaurosis fugax
transient, painless visual loss
what is seen on fundoscopy of amaurosis fugax
no abnormal signs
management of amaurosis fugax
refer to stroke clinic
clinical presentation of branch retinal artery occlusion
acute onset of painless monocular visual impairment
fundoscopy of branch retinal artery occlusion
absence of perfusion in the affected artery
management of branch retinal artery occlusion
refer to stroke clinic
what happens as a result of central retinal artery occlusion
infarction of the inner 2/3 of the retina
name 3 causes of central retinal artery occlusion
carotid artery disease !!!
emboli from the heart
giant cell arteritis
symptom of central retinal artery occlusion
sudden, painless, SEVERE loss of vision
clinical sign of central retinal artery occlusion
RAPD
what is RAPD
relative afferent pupil defect
3 findings on fundoscopy of central retinal artery occlusion
arteries become thread like
retina is pale, opaque and oedematous
cherry-red spot seen at the fovea
management of central retinal artery occlusion
immediate referral to stroke clinic
3 factors that increase chance of retinal vein occlusion
VIRCHOW’S TRIAD
- endothelial damage
- abnormal blood flow
- hypercoagulable state
central retinal vein occlusion
thrombus forms in the retinal veins and blocks the drainage of blood from the retina
branch retinal vein occlusion
venous occlusion at any branch of the central retinal vein resulting in visual problems in the area drained by that branch
what happens when a retinal vein is blocked
pooling of blood in the retina leading to macular oedema and retinal haemorrhages
why can retinal vein occlusion lead to neovascularisation
release of VEGF
symptom of retinal vein occlusion
sudden painless loss of vision
4 findings on fundoscopy of retinal vein occlusion
- Flame and blot haemorrhages
- Optic disc oedema
- Macula oedema
- Dilated tortuous veins
management of retinal vein occlusion
IMMEDIATE REFRRAL TO OPHTHALMOLOGY
laser photocoagulation, intravitreal steroids, anti-VEGF
what is vitreous haemorrhage
bleeding in the vitreous cavity
what are the 2 main mechanisms that cause vitreous haemorrhage
rupture of normal vessels from mechanical force
haemorrhage from pathological structures
name 2 causes of retinal neovascularisation
diabetic retinopathy
retinal vein occlusion
2 main symptoms of vitreous haemorrhage
sudden, painless visual loss or haze
new onset floaters
clinical sign of vitreous haemorrhage
loss of fundal reflex
