central retinal artery occlusion


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central retinal artery occlusion

Abbreviation: CRAO
Blockage of blood flow to the retina (that is, to the central retinal artery or one of its branches), resulting in sudden visual loss. The condition usually affects one eye. When the retinal artery is blocked by a blood clot, early thrombolysis sometimes provides sight-preserving therapy.

Etiology

CRAO is typically caused by a tiny embolus that lodges in the retinal circulation. It usually occurs in people with high blood pressure, diabetes mellitus, cardiac valve disease, or atrial fibrillation, which predispose to atherosclerosis or arterial embolization. Other causes include inflammatory or autoimmune diseases affecting the circulation (arteritis), clotting disorders, hyperlipidemia, injected drugs or contaminants, and tumor metastases.

See also: occlusion

retinal arterial occlusion 

Occlusion of the central retinal artery (CRAO) is characterized by a sudden loss of vision and a defective direct pupil light reflex. The retinal arterioles are constricted while the veins are full but a venous pulse is absent. The retina appears white and swollen, especially near the posterior pole, and the choroid is seen through it as a cherry-red spot (Fig. S12). If the occlusion persists the cherry-red spot disappears after several weeks, the retinal arterioles remain attenuated, eventually becoming white threads, and the optic disc becomes atrophic.Occlusion is more frequently limited to one branch of the central retinal artery (BRAO). In this case, the clinical picture is limited to the area supplied by the branch and this is associated with a visual field defect in that region. Causes include retinal emboli due to a cardiovascular disease, systemic hypertension, temporal arteritis, oral contraceptives, syphilis, intravenous drug abuse or trauma. Treatment is urgent as there is an extremely serious risk of blindness. See amaurosis fugax; fluorescein angiography; atheroma; Hollenhorst's plaques; cherry-red spot.
Fig. S12 Cherry-red spot at the maculaenlarge picture
Fig. S12  Cherry-red spot at the macula
References in periodicals archive ?
Serjeant, "Central retinal artery occlusion without retrobulbar hemorrhage after retrobulbar anesthesia," American Journal of Ophthalmology, vol.
INCLUSION CRITERIA: Non-arteritic Central retinal artery occlusion with thromboembolic origin.
EXCLUSION CRITERIA: Arteritic, transient ischaemia and with a Central retinal artery occlusion preserved cilioretinal vessel.
Aggressive systematic treatment for central retinal artery occlusion. Am J Ophthalmol 1999; 128 (6): 733-8.
Central retinal artery occlusion: local intra-arterial fibrinolysis versus conservative treatment, a multicenter randomized trial.
(4.) Hattenbach LO, Kuhli-Hattenbach C, Scharrer I, Baatz H.Intravenous thrombolysis with lowdose recombinant tissue plasminogen activator in central retinal artery occlusion. Am J Ophthalmol 2008; 146 (5): 700-6.
Evaluation of minimally invasive therapies and rationale for a prospective randomized trial to evaluate selective intra-arterial lysis for clinically complete central retinal artery occlusion. Arch Ophthalmol 2003; 121 (10): 1377-81.
(15.) Hayreh SS, Zimmerman MB: Central retinal artery occlusion: visual outcome.
RESULTS: Central Retinal Artery Occlusion right eye secondary to primary antiphospholipid syndrome with high titres anti-beta-2-glycoprotein I antibodies

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