Retinal artery occlusion

Introduction The cause of retinal vascular occlusion is mostly caused by arterial spasm, but it can also be caused by embolism (such as endocarditis, embolus formed by cardiac surgery) or thrombosis (such as endarteritis). Because the central retinal artery is a peripheral blood vessel, there is no collateral connection. Once the obstruction occurs, the retinal ischemia, hypoxia, edema, degeneration, necrosis and even atrophy of the blood supply area will be severely damaged. The central retinal artery is the terminal artery, and its obstruction causes acute ischemia of the retina, and the visual acuity is seriously degraded, which is one of the blind emergencies.

Cause

The direct causes of retinal vascular occlusion are mainly vascular embolism, vasospasm, changes in blood vessel wall and thrombosis, and compression of blood vessels from the outside. The central retinal artery occlusion is often a multifactorial disease, which is the basis of vascular disease. Combined with embolism or other inducement, it may cause disease. Including cardiovascular disease, hypertension, nephritis, diabetes, acute infectious diseases, tumors, inflammation.

an examination

1. Pay attention to the onset time and the speed and degree of vision loss.

2. Check vision, fundus (with or without arterial pulsation, bleeding distribution characteristics, morphology and vascular changes, visual field).

3. Etiology check, including cardiovascular disease, hypertension, nephritis, diabetes, acute infectious diseases, tumors, inflammation and lesions.

4. Blood routine, platelets, bleeding time, clotting time, X-ray chest and so on.

5. Fluorescein fundus angiography, electroretinogram and electrooculogram.

Differential diagnosis

Anterior ischemic optic neuropathy

Often the two eyes have a history of onset, the fundus is characterized by obvious papillary edema, mild or moderate visual acuity, and the typical damage of the visual field is a curved dark spot connected to the physiological blind spot.

2. Ocular artery occlusion

Visual function damage is more serious, and vision is usually light or lack of light. Reduced intraocular pressure, retinal edema is more serious, and there can be no "cherry red" in the macular area.

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