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Central Retinal Artery Occlusion

Central Retinal Artery Occlusion is a topic covered in the 5-Minute Emergency Consult.

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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 1st 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
  • Thrombotic:
    • Obstruction of flow from the rupture of a pre-existing intravascular atherosclerotic plaque
    • Hypercoagulable states (sickle cell)
  • Inflammatory:
    • Due to 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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Citation

Rosen, Peter, et al., editors. "Central Retinal Artery Occlusion." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307610/all/Central_Retinal_Artery_Occlusion.
Central Retinal Artery Occlusion. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307610/all/Central_Retinal_Artery_Occlusion. Accessed April 23, 2019.
Central Retinal Artery Occlusion. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307610/all/Central_Retinal_Artery_Occlusion
Central Retinal Artery Occlusion [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 23]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307610/all/Central_Retinal_Artery_Occlusion.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Central Retinal Artery Occlusion ID - 307610 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307610/all/Central_Retinal_Artery_Occlusion PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -