A young patient comes with a history of sudden painless loss of vision, with a systolic murmur. Ocular examination reveals a bright red spot in the retina with a clear anterior chamber. The likely diagnosis is:
|A.||Central Retinal Artery Occlusion|
Central Retinal Vein Occlusion
Branch Retinal Vein Occlusion
Answer: A. Central Retinal Artery Occlusion
Explanation:Central retinal artery occlusion is a rare but one of the ophthalmological emergencies with worse prognosis that causes definite loss of vision within few hours of installation. Assimilated to the ocular analogue of cerebral stroke, it results on impaired functional capacity and quality of life. After initial measures, further investigations are necessary and can suggest the etiology of the CRAO.
Typical funduscopic findings of a pale retina with a cherry red macula result from obstruction of blood flow to the retina from the retinal artery, causing pallor, and continued supply of blood to the choroid from the ciliary artery, resulting in a bright red coloration at the thinnest part of the retina.
Previously undiagnosed vascular risk factors are found in about 78% of all CRAO patients. The most meaningful risk factor being ipsilateral carotid artery stenosis. A comprehensive and prompt diagnostic work-up is mandatory for all CRAO patients.
Cherry red spot in CRAO