Central Retinal Artery Occlusion And Branch Retinal Artery

(Amaurosis fugax)

A closure of the central retinal artery occurs when it is blocked, usually due to an embolism. This causes sudden, painless, unilateral and severe loss of vision normally. Diagnosis is based on history and the characteristic retinal findings in Funduscopy. A reduction of the intraocular pressure can be carried out within the first 24 hours of occlusion, to attempt removal of the embolus. When patients are admitted within the first few hours after an occlusion, some centers catheterize the jugular vein / artery eyes and inject selectively thrombolytics.

A closure of the central retinal artery occurs when it is blocked, usually due to an embolism. This causes sudden, painless, unilateral and severe loss of vision normally. Diagnosis is based on history and the characteristic retinal findings in Funduscopy. A reduction of the intraocular pressure can be carried out within the first 24 hours of occlusion, to attempt removal of the embolus. When patients are admitted within the first few hours after an occlusion, some centers catheterize the jugular vein / artery eyes and inject selectively thrombolytics. Etiology Retinal artery occlusion may be due to embolism or thrombosis. Embolism can be caused by: Atherosclerotic plaques endocarditis fat atrial myxoma thrombosis is a less common cause of retinal artery occlusion, but can be used with systemic vasculitis such as SLE and giant cell arteritis (giant cell arteritis), which is an important cause of arterial occlusion that requires immediate diagnosis and treatment , be seen. The occlusion can affect a retinal branch artery and the central retinal artery. Neovascularization (abnormal vessels formation) of the retina or iris (diabetic retinopathy) with secondary (neovascular) glaucoma occurs in about 20% of patients within weeks or months after occlusion on. Retinal neovascularization can lead to vitreous hemorrhage. Symptoms and signs A Retinal artery occlusion leads unilateral sudden, painless loss of vision or severe visual field defect, usually. Even if the pupil to direct illumination reacts only weakly narrowed it down immediately when lit up in the other eye (relative afferent pupillary defect). In acute cases, the funduscopy shows a pale opaque fundus with red fovea (cherry-red spot). Usually, the arteries are diluted and appear in some cases even anemic. (Called z. B. a cholesterol embolism, Hollenhorst plaque) an embolism is sometimes visible. If only one main branch, but not all the artery is occluded, the fundus changes and the loss of vision limited to the corresponding Retina sector. Patients with giant cell arteritis are 55 or older and headaches, sensitive and palpabele temporal artery, jaw claudication, fatigue, or a combination of these may have. Diagnosis Clinical Investigation color fundus photography and fluorescein angiography Diagnosis is suspected when a patient has an acute, painless, severe visual loss. Usually a Funduscopy confirmed the diagnosis. The fluorescein angiography is often performed and shows lack of perfusion in the affected artery. After diagnosis, Doppler sonography of the carotid artery and an echocardiogram to determine a source of embolism should be done so that further embolization can be prevented. If giant cell arteritis is suspected, immediately ESR, C-reactive protein and platelet counts should be done. These tests are not necessary if an embolic plaque in the central retinal artery is visible. Central retinal artery occlusion Image courtesy of Robert Machemer via the Online Journal of Ophthalmology (www.onjoph.com). var model = {thumbnailUrl: ‘/-/media/manual/professional/images/central_retinal_artery_occlusion_high_de.jpg?la=de&thn=0&mw=350’ imageUrl: ‘/-/media/manual/professional/images/central_retinal_artery_occlusion_high_de.jpg?la = en & thn = 0 ‘, title:’ Retinal central retinal artery occlusion ‘, description:’ u003Ca id = “v37894300 ” class = “”anchor “” u003e u003c / a u003e u003cdiv class = “”para “” u003e u003cp u003eBei acute central retinal artery occlusion can diffuse retinal edema become faded the retina and arteries. The underlying vascularized choroid shows through the thin fovea the typical cherry-red spot u003c / p u003e u003c / div u003e ‘credits’. Image courtesy of Robert Machemer via the Online Journal of Ophthalmology (www.onjoph. . com) ‘hideCredits: false

Health Life Media Team

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