Clinical Diagnosis, Classification and Differential Diagnosis in Retinal Artery Occlusion

10.37783/0188 ◽  
2020 ◽  
pp. 9-12
Keyword(s):  
Central Retinal Artery Occlusion ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Fundus Fluorescein Angiography ◽  
Cotton Wool Spots ◽  
Vein Occlusion ◽  
Cilioretinal Artery Occlusion ◽  
Cilioretinal Artery ◽  
Retinal Artery ◽  
Patient’S History

A retinal artery occlusion is an ophthalmic emergency requiring immediate systemic evaluation because it is a summoner to stroke. Diagnosis is usually prompted by the patient’s history and fundus examination. Fundus fluorescein angiography (FFA) and optical coherence tomography are routinely used in clinical evaluation. Retinal artery occlusions are clinically classified as central retinal artery occlusion (CRAO), branch retinal artery occlusion (BRAO), cilioretinal artery occlusion (CLRAO), combined retinal artery and vein occlusion, cotton-wool spots and a newly defined entity paracentral acute middle maculopathy (PAMM).

scholarly journals Central retinal artery and vein occlusion as a complication of persistent hyaloid artery – a case report

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Mirjana Bjeloš ◽  
Ana Križanović ◽  
Mladen Bušić ◽  
Biljana Kuzmanović Elabjer
Keyword(s):  
Case Report ◽  
Central Retinal Artery Occlusion ◽  
Retinal Artery Occlusion ◽  
Neovascular Glaucoma ◽  
Artery Occlusion ◽  
Central Retinal Artery ◽  
Venous Stasis ◽  
Vein Occlusion ◽  
Arterial Inflow ◽  
Retinal Artery

Abstract Background In this case report, we present for the first time central retinal artery occlusion (CRAO) and central retinal vein occlusion (CRVO) as a complication of persistent hyaloid artery (PHA). Case presentation In August 2019, a six-year-old male patient manifested right eye (RE) excessive tearing, conjunctival injection and pain. On examination, RE demonstrated light perception and intraocular pressure of 36 mmHg. The diagnoses of neovascular glaucoma, CRVO and CRAO were established as affirmed with fluorescein angiography (FA). PHA was not reported. Extensive work-up and family history were unremarkable. The child was born on term after uncomplicated twin pregnancy. In December 2019, he was referred to our Centre. Transillumination revealed fully dilated, non-reactive RE pupil, clear lens and tubular remnant of HA containing blood cells in its lumen freely rotating in the anterior vitreous. Conclusions PHA results from failure of apoptosis during gestation. It can easily be observed during the red reflex screening at neonatal wards. We hypothesized that PHA twisting led to torsion of the residual primordial common bulb, branching off to HA and CRA with CRAO occurring first. The consequential CRVO presumably advanced by venous stasis due to decrease in arterial inflow. Liquid vitreous appears as early as 4 years of age enabling PHA to whirl more freely. Thus, in case of PHA, we advocate FA to be performed and if connection with retinal artery is proven, parents should be informed on the possible devastating complications and prompt surgical treatment should be considered.

The effect of adjunctive hyperbaric oxygen therapy in patients with central retinal artery occlusion

2020 ◽  
pp. 57-64
Author(s):  
Yoon-Seop Kim ◽  
◽  
Myung-Sik Nam ◽  
Eung Joo Park ◽  
Yoonsuk Lee ◽  
...  
Keyword(s):  
Hyperbaric Oxygen ◽  
Central Retinal Artery Occlusion ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Central Retinal Artery ◽  
Medical Society ◽  
Corrected Visual Acuity ◽  
Visual Improvement ◽  
Cilioretinal Artery ◽  
Retinal Artery

Purpose: Central retinal artery occlusion (CRAO) is an ophthalmic emergency with poor prognosis, despite diligent conventional treatment. According to the clinical recommendations of the Undersea and Hyperbaric Medical Society hyperbaric oxygen (HBO2) is a potentially beneficial treatment; however, the benefit of adjunctive HBO2 in patients with CRAO in Korea remains unclear. The present study aimed to evaluate the effect of adjunctive HBO2 in patients with CRAO. Methods: This registry-based observational study included adult patients who presented to the emergency department or ophthalmology outpatient department within 24 hours of the onset of CRAO symptoms. Data of patients from October 2016 to February 2019 were analyzed. The patients were categorized into two groups according to the use of adjunctive HBO2: no HBO2 and HBO2. Result: During the study period, 34 consecutive patients were enrolled, of which 19 were included in the study. In the total cohort, 10 patients (52.6%) were treated with adjunctive HBO2. There were no statistically significant differences in terms of age, sex, comorbidities, duration from symptoms onset to hospital visit, presence of the cilioretinal artery, and use of anterior chamber paracentesis between the two groups. The HBO2 group showed significantly higher change in best-corrected visual acuity than the no-HBO2 group (p=0.043). Conclusion: Patients with CRAO in the HBO2 group showed significantly greater visual improvement than those in the no HBO2 group. Clinicians should consider adjunctive HBO2 in the treatment approach in patients with CRAO who visit the hospital within 24 hours of symptoms onset.

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