Diagnose the Underlying condition shown in the Fundus Photograph
A. Central Retinal artery occlusion
B. Diabetic retinopathy
C. Hypertensive retinopathy
D. Optic atrophy
Ans : A. Central Retinal artery occlusion
Central retinal artery occlusion (CRAO).
- It occurs due to obstruction at the level of lamina cribrosa.
- Patient complains of sudden painless loss of vision.
- Direct pupillary light reflex is absent.
- On ophthalmoscopic examination retinal arteries are markedly narrowed but retinal veins look almost normal. Retina becomes milky white due to oedema.Central part of the macular area shows cherry-red spot due to vascular choroid shining through the thin retina of this region. .Blood column within the retinal veins is segmented (cattletrucking). After a few weeks the oedema subsides, and atrophic changes occur which include grossly attenuated thread-like arteries and consecutive optic atrophy.
- Immediate lowering of intraocular pressure by intravenous mannitol and intermittent ocular massage.
- Vasodilators and inhalation of a mixture of 5 percent carbon dioxide and 95 percent oxygen
- Intravenous steroids are indicated in patients with giant cell arteritis.
- Neovascular glaucoma