Central Retinal Artery Occlusion
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Basics
Description
- Obstruction of the central retinal artery associated with sudden painless loss of vision
- Usually occurs in persons 50–70 yr of age
- Ophthalmic artery is the first branch of carotid
- Risk factors include HTN, atherosclerotic disease, sickle cell disease, vasculitis, valvular heart disease, lupus, trauma, and coronary artery disease
- Incidence of 1–10/100,000
- Often described as a “stroke of the eye”
Etiology
- Embolic:
- Occlusion by intravascular material from a proximal source:
- Atherosclerotic disease (majority)
- Carotid artery stenosis
- Valvular heart disease (cardiogenic emboli)
- Atrial myxoma
- Dissection of the ophthalmic artery
- Carotid artery dissection
- Occlusion by intravascular material from a proximal source:
- Thrombotic:
- Obstruction of flow from the rupture of a pre-existing intravascular atherosclerotic plaque
- Hypercoagulable states (sickle cell)
- Inflammatory:
- Due to giant cell arteritis, temporal arteritis, lupus, vasculitis
- Arterial spasm:
- Associated with migraine headaches
- Decreased perfusion:
- Low-flow conditions such as in severe hypotension or high-pressure situations seen in acute angle-closure glaucoma or retrobulbar hemorrhage
-- To view the remaining sections of this topic, please log in or purchase a subscription --
Basics
Description
- Obstruction of the central retinal artery associated with sudden painless loss of vision
- Usually occurs in persons 50–70 yr of age
- Ophthalmic artery is the first branch of carotid
- Risk factors include HTN, atherosclerotic disease, sickle cell disease, vasculitis, valvular heart disease, lupus, trauma, and coronary artery disease
- Incidence of 1–10/100,000
- Often described as a “stroke of the eye”
Etiology
- Embolic:
- Occlusion by intravascular material from a proximal source:
- Atherosclerotic disease (majority)
- Carotid artery stenosis
- Valvular heart disease (cardiogenic emboli)
- Atrial myxoma
- Dissection of the ophthalmic artery
- Carotid artery dissection
- Occlusion by intravascular material from a proximal source:
- Thrombotic:
- Obstruction of flow from the rupture of a pre-existing intravascular atherosclerotic plaque
- Hypercoagulable states (sickle cell)
- Inflammatory:
- Due to giant cell arteritis, temporal arteritis, lupus, vasculitis
- Arterial spasm:
- Associated with migraine headaches
- Decreased perfusion:
- Low-flow conditions such as in severe hypotension or high-pressure situations seen in acute angle-closure glaucoma or retrobulbar hemorrhage
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