Central Retinal Artery & CRVOcauses, symptoms and treatments

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Last updated 10/2/2019
central-retinal-artery-occlusion, Assil Eye Institute

What's central retinal artery occlusion (CRAO)? 

The Central Retinal Artery is the key artery responsible for carrying oxygen rich blood to the nerve cells that make up the retina lining the back of your eye. If this artery gets blocked by a blood clot or a bit of cholesterol, it robs the retinal cells of oxygen and they begin to die off.

 

Without restoration of blood flow, the retina can survive only approximately 4-6 hours. Essentially, this is a “stroke of the eye.” The typical symptom of a CRAO is sudden onset of painless vision loss.

 

Unfortunately, at this time there is no proven effective therapy for CRAO and administration of thrombolytic agents is not advised.

 

The most important part of the treatment is immediate stroke-protocol work up and patients are typically referred to Emergency Room for full evaluation of the heart, ultrasound of the carotid arteries in the neck as a possible emboli source, and urgent assessment of all stroke risk factors.

What's central retinal vein occlusion (CRVO)?

Sometimes the main vein responsible for carrying away de-oxygenated blood from the retina becomes partially or completely blocked. This can cause pressure build up in the retinal vessels, making them leak blood (this appears as retinal hemorrhages) and fluid into the layers of the central retina (macular edema).

 

Swelling and bleeding in the retina affects vision. The degree of vision loss depends on the extent of vein blockage and the size of the affected blood vessel. The most common risk factor for this condition is high blood pressure, diabetes, high cholesterol, and smoking.

 

Treatment involves focusing on risk factor control to prevent development of he same condition in the other eye, as well as management of macular edema (swelling) using intraocular injections.

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