CRVO and CRAO -JUST BASIC !

undergraduates may benefit !

1. Retinal vascular diseases
Dr Nitish

2. CRAO
•ETILOGY
•EMBOLI FROM CAROTID ARTERY
•VALVULAR HEART DISEASES
•THROMBUS FROM ARTERIO SCLEROSIS
•HYPERTENSION
•ARTERITIS.

3. SYMPTOMS
•PAINLESS SUDDEN UNILATERAL LOSS OF
VISION.
•AMAUROSIS FUGAX

4. SIGNS
•LARGER ARTERIES THREAD LIKE AND
ARTERIOLES ARE INVISIBLE.
•VEINS NORMAL .
•FEW HOURS THE RETINAL LOSES ITS
TRANSPARENCY AND BECOME MILKY WHITE.
•CHERRY RED SPOT

5. CHERRY RED SPOT
•CRAO
•BERLIN’S EDEMA
•TAY SACH’S S DISEASE
•NIEMANN PICK DISEASE
•SANDHOFF’S DISEASE
•QUININE AMBLOPIA.

6. SIGN’S CONT’D
•CATTLE TRUCK APPEARANCE.
•AFTER A WK OR SO THE RETINA RESUMES
NORMAL APPEARNECE AND ON BECOMES
ATROPHIC AND APPEARS WHITE.
•NO PL

7. BRAO
•AT BIFURCATION.
•ATHEROMATOUS EMBOLI SEEN INSIDE THE
ARTERY- HOLLENHORST PLAQUE.

8. TREATMENT
•DIGITAL MASSAGE.
•IV ACETAZOLAMIDE.
•5% CO2 AND 95% O2 MIXTURE OF 10 MIN.
•PARACENTSIS.
•RETROBULBAR INJECTION OF ACETYLCHOLINE.
•ANTI COAGULANTS.

9. PROGNOSIS
•> 6HRS NO RETURN OF MACULAR VISION.

10. CRVO
•CENTRAL/ BRANCH RETINAL VEIN.
•AGE: 6
th
/7
th
decade.
•Systemic hypertension: compressed by a
thickened artery where the 2 share common
adventitia.
•Raised IOP
•Diabetes
•Hyperviscosity syndrome.

11. Pathogenesis
External compression on the vein
Venous stasis
Degenerative disease of the venous
endothelium.

12. Types
•Non ischaemic
•Ischaemic

13. Non ischaemic
•VA
•RAPD

14. FUNDUS
•MILD TORTUOSITY AND DILTATION .
•H’AGES-DOT n BLOT , FLAME SHAPED H’ GES.
•COTTON WOOL EXUDATES ABSENT
•MILD TO MODERATE DISC EDEMA.
•MACULAR EDEMA

15. ISCHAEMIC CRVO
•VA DECREASED.
•SUPERFICIAL AND DEEP HAEMORRHAGES.
•CW.
•OPTIC DISC EDEMA
•BLOOD AND THUNDER FUNDUS

16. COMPLICATIONS
•RUBEOSIS IRIDIS
•NEOVASCULAR GLAUCOMA.
•VH.
•NVD.
•NVE.

17. TREATMENT
•PRP