CRAO AND CRVO

CENTRAL RETINAL ARTERY AND VEIN OCCLUSION

1. CRAO & CRVO Harshali Vijay Mestri 2 nd Year B-optometry ITM-IHS

2. CRAO & CRVO is the common vascular disorder of Retina # Central Retinal A rtery Occlusion{CRAO}# It occurs due to obstruction at the level of Lamina cribrosa. Clinically Retinal Artery Occlusion may present as Central Retinal Artery occlusion (60%). It is more common in males than females. It is usually unilateral but rarely may be bilateral(1 to 2%cases).

3. Central Retinal Artery Occlusion

4. RETINAL ARTERY OCCLUSION Definitions: Vascular disorder of retina resulting in sudden painless loss of vision with antecedent transient visual loss. Types: 1.Cenral retinal artery occlusion 2.Branch retinal artery occlusion

5. Etiology 1.Thrombosis due to atherosclerosis 2.Embolism 3.Raised intra ocular pressure 4.Giant Cell Arteritis 5.Angiospasm- Retinal Migraine

6. Symptoms Patients complains of sudden painless loss of vision occurring over seconds. Patients may give history of transient visual loss in (amaurosis fugax) the past

7. Clinical Examination Visual Acuity severely reduced between counting finger and light perception. Direct pupillary light reflex- absent. Fundus Examination- whitish appearance of retina. Thin retinal arteries, segmented blood column in retinal vessels. Cherry red spot at macula , pale appearance of optic disc

8. Treatment Intraocular pressure lowered immediately by anterior chamber paracentasis or I.V. Acetazolamide. Inhaled oxygen and carbon dioxide mixture to improve oxygen delivery to retina. Thrombolytic therapy .

9. RETINAL VEIN OCCLUSION Definition : It’s a common vascular disorder characterized by retinal vein occlusion resulting in edema and hemorrhages on retina in the affected region with potential blinding complications. Types : Central retinal vein occlusion Branch retinal vein occlusion

10. CENTRAL RETINAL VEIN OCCLUSION

11. Central retinal vein occlusion CRVO is an end vein, its occlusion leads to complete defective of vision in the morning. These typically affect elderly patients in sixth or seventh decade of life. It may be Non-ischemic CRVO (venous stasis retinopathy) or Ischemic CRVO (haemorrhagic retinopathy).

12. ETIOLOGY & RISK FACTORS Age of age above 30 years. Systemic diseases like hyperlipidemia, diabetes, chronic renal failure. Chronic open angle glaucoma.

13. NON- ISCHAEMIC CRVO Non ischemic CRVO is the most common clinical variety (75%). It is characterized by mild to moderate visual loss and no RAPD.

14. ISCHEMIC CRVO Ischemic CRVO refers to acute complete occlusion of central retinal vein. It is characterized by marked sudden visual loss and RAPD.

15. S ymptoms Sudden painless loss of vision. Persistent decreased central vision.

16. Clinical Examination Visual acuity- severe visual loss, up to 20/200. Intra ocular pressure raised Fundus Examination- dilated tortuous veins, retinal and macular edema, flame shape hemorrhages and cotton wool spots .

17. INVESTIGATION FLUORESCEIN ANGIOGRAPHY ECG BLOOD CP BLOOD GLUCOSE LEVEL. COMPLICATION CHRONIC MACULAR EDEMA RETINAL NEOVASCULARIZATION NEOVASCULAR GLAUCOMA CONVERSION FROM NON-ISCHEMIC TO ISCHEMIC TYPE .

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