Central retinal artery occlusion: Difference between revisions

No edit summary
No edit summary
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#Inflammatory Endarteritis
#Inflammatory Endarteritis


==Epidemiology==
===Epidemiology===
#Bilateral 1-2%
#Bilateral 1-2%
#M>F
#M>F
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==Exam==
==Exam==
#Pale retina with edema
#Cherry red spot at the macula
#APD
#Boxcar segmentation of blood column


Pale retina with edema
==Workup==
 
#Fundoscopic exam
Cherry red spot at the macula
#CBC, ESR, EKG
 
APD
 
Boxcar segmentation of blood column
 
 
==W/U==
 
 
Fundoscopic exam
 
CBC, ESR, EKG
 


==Treatment==
==Treatment==
 
# Ocular massage
 
# Anterior chamber paracentesis
1. Ocular massage
# Intraarterial fibrinolysis
 
# Acetazolamide
2. Anterior chamber paracentesis
# Mannitol
 
# Timolol
3. Intraarterial fibrinolysis
# Steroids
 
# Hyperbarics (most effective if within 2-12h of presentation)
4. Acetazolamide
 
5. Mannitol
 
6. Timolol
 
7. Steroids
 
8. Hyperbarics (most effective if within 2-12h of presentation)
 


==Dispo==
==Dispo==
Admit: comorbid disease
Admit: comorbid disease


D/C: f/u with ophtho in 1-4 weeks
D/C: f/u with ophtho in 1-4 weeks


==Source==
==Source==
H-N
H-N


[[Category:Ophtho]]
[[Category:Ophtho]]

Revision as of 10:42, 29 March 2011

Background

Etiology

  1. Retinal Embolism (20%)
  2. Atherosclerotic changes
  3. Angiospasm
  4. Inflammatory Endarteritis

Epidemiology

  1. Bilateral 1-2%
  2. M>F

Symptoms

Painless, monocular loss of vision

DDx

  1. Amaurosis fugax (painless, fleeting; nl exam)
  2. CRVO (painless, over hours; blood and thunder)
  3. Temporal Arteritis
  4. Acute glaucoma (blurry vision, eye pain)

Exam

  1. Pale retina with edema
  2. Cherry red spot at the macula
  3. APD
  4. Boxcar segmentation of blood column

Workup

  1. Fundoscopic exam
  2. 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