Central retinal artery occlusion: Difference between revisions
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==Etiology== | ==Background== | ||
===Etiology=== | |||
#Retinal Embolism (20%) | |||
Retinal Embolism (20%) | #Atherosclerotic changes | ||
#Angiospasm | |||
Atherosclerotic changes | #Inflammatory Endarteritis | ||
Angiospasm | |||
Inflammatory Endarteritis | |||
==Epidemiology== | ==Epidemiology== | ||
#Bilateral 1-2% | |||
#M>F | |||
Bilateral 1-2% | |||
M>F | |||
==Symptoms== | ==Symptoms== | ||
Painless, monocular loss of vision | Painless, monocular loss of vision | ||
==DDx== | ==DDx== | ||
#Amaurosis fugax (painless, fleeting; nl exam) | |||
#CRVO (painless, over hours; blood and thunder) | |||
Amaurosis fugax (painless, fleeting; nl exam) | #Temporal Arteritis | ||
#Acute glaucoma (blurry vision, eye pain) | |||
CRVO (painless, over hours; blood and thunder) | |||
Temporal Arteritis | |||
Acute glaucoma (blurry vision, eye pain) | |||
==Exam== | ==Exam== | ||
Pale retina with edema | Pale retina with edema | ||
Revision as of 10:31, 29 March 2011
Background
Etiology
- Retinal Embolism (20%)
- Atherosclerotic changes
- Angiospasm
- Inflammatory Endarteritis
Epidemiology
- Bilateral 1-2%
- M>F
Symptoms
Painless, monocular loss of vision
DDx
- Amaurosis fugax (painless, fleeting; nl exam)
- CRVO (painless, over hours; blood and thunder)
- Temporal Arteritis
- Acute glaucoma (blurry vision, eye pain)
Exam
Pale retina with edema
Cherry red spot at the macula
APD
Boxcar segmentation of blood column
W/U
Fundoscopic exam
CBC, ESR, EKG
Treatment
1. Ocular massage
2. Anterior chamber paracentesis
3. Intraarterial fibrinolysis
4. Acetazolamide
5. Mannitol
6. Timolol
7. Steroids
8. Hyperbarics (most effective if within 2-12h of presentation)
Dispo
Admit: comorbid disease
D/C: f/u with ophtho in 1-4 weeks
Source
H-N