Retinal artery occlusion

Question 1

Retinal artery occlusion

Answer 1

Examine this man’s fundi.

Question 2

Clinical signs of Retinal artery occlusion

Answer 2

1. Pale, milky fundus with thread‐like arterioles
2. ± Cherry red macula (choroidal blood supply)
3. Cause: AF (irregular pulse) or carotid stenosis (bruit)
4. Effect: optic atrophy and blind (white stick)
   » Note that branch retinal artery occlusion will have a field defect opposite to the quadrant of affected retina

Question 3

Causes of Retinal artery occlusion

Answer 3

1. Embolic: carotid plaque rupture or cardiac mural thrombus
   » Treatment: aspirin, anti‐coagulation and endarterectomy
2. Giant cell arteritis: tender scalp and pulseless temporal arteries
   » Treatment: high‐dose steroid urgently, check ESR and arrange temporal artery biopsy to confirm diagnosis