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Retinal vascular diseases
Dr Nitish
CRAO
• ETILOGY
• EMBOLI FROM CAROTID ARTERY
• VALVULAR HEART DISEASES
• THROMBUS FROM ARTERIO SCLEROSIS
• HYPERTENSION
• ARTERITIS.
SYMPTOMS
• PAINLESS SUDDEN UNILATERAL LOSS OF
VISION.
• AMAUROSIS FUGAX
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
CHERRY RED SPOT
• CRAO
• BERLIN’S EDEMA
• TAY SACH’S S DISEASE
• NIEMANN PICK DISEASE
• SANDHOFF’S DISEASE
• QUININE AMBLOPIA.
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
BRAO
• AT BIFURCATION.
• ATHEROMATOUS EMBOLI SEEN INSIDE THE
ARTERY- HOLLENHORST PLAQUE.
TREATMENT
• DIGITAL MASSAGE.
• IV ACETAZOLAMIDE.
• 5% CO2 AND 95% O2 MIXTURE OF 10 MIN.
• PARACENTSIS.
• RETROBULBAR INJECTION OF ACETYLCHOLINE.
• ANTI COAGULANTS.
PROGNOSIS
• > 6HRS NO RETURN OF MACULAR VISION.
CRVO
• CENTRAL/ BRANCH RETINAL VEIN.
• AGE: 6th
/7th
decade.
• Systemic hypertension: compressed by a
thickened artery where the 2 share common
adventitia.
• Raised IOP
• Diabetes
• Hyperviscosity syndrome.
Pathogenesis
External compression on the vein
Venous stasis
Degenerative disease of the venous
endothelium.
Types
• Non ischaemic
• Ischaemic
Non ischaemic
• VA
• RAPD
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
ISCHAEMIC CRVO
• VA DECREASED.
• SUPERFICIAL AND DEEP HAEMORRHAGES.
• CW.
• OPTIC DISC EDEMA
• BLOOD AND THUNDER FUNDUS
COMPLICATIONS
• RUBEOSIS IRIDIS
• NEOVASCULAR GLAUCOMA.
• VH.
• NVD.
• NVE.
TREATMENT
• PRP

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