Considered to be a form of a stroke with similar clinical approach and management
Incidence is low with less than 10 in 100,00
Average age is 60-65 with men more commonly affected and RF of HTN, smoking and diabetes
Most common etiology is carotid artery atherosclerosis, especially in older patients. Other etiologies common in the elderly include cardioembolic disease, carotid artery dissections, hypercoagulable states and vascultitis
Central retinal artery occlusion and branch retinal artery occlusion present with acute, painless loss of monocular vision
Central retinal artery occlusion: acute and profound loss of vision in one eye, often painless, can be preceded by transient monocular blindness or a stuttering, fluctutaing course
Branch retinal artery occlusion: acute monocular vision loss that may be restricted to part of the visual field, with less than half of patients having impaired visual acuity
On funduscopic exam with CRAO you will see a “cherry red spot” in the macula with ischemic retinal whitening due to the occlusion +/- retinal emboli.
For BRAO there is a sectoral pattern to the retinal opacification +/- retinal emboli.
Definitive diagnosis is rarely needed, but can be confirmed with fluorescein angiography
Treatment: OCULAR EMERGENCY
Can attempt occular massage, anterior chamber paracentesis, mannitol or acetazolamide can reduce IOP, vasodilator medications or hyperbaric oxygen
In selected patients, ophtho can do intra-arterial thrombolysis or surgical revascularization