Edit concept Question Editor Create issue ticket

Retinal Arterial Branch Occlusion

BRAO


Presentation

  • No hemorrhage recurrence or further complications presented during the 12-month follow-up. Figure 1. (A) Left eye fluoresceing angiography showing a prepapillary arterial loop.[em-consulte.com]
  • […] of the obstructed artery is the typical history of presentation.[en.wikipedia.org]
  • Schaal and Sigford present the novel treatment of a central retinal artery occlusion with 25-gauge pars plana vitrectomy. A 61-year-old gentleman presented with acute vision loss in his right eye for 5 hours.[eyetube.net]
  • Branch Retinal Vein Occlusion (BRVO) Baseline Patient 60 years, male presented with decreased vision.[od-os.com]
  • Case presentation: A 50 year-old woman presented with acute visual loss in her right eye. Fundus photography showed retinal ischemia and tortuous, dilated retinal veins in the right eye.[dovepress.com]
Coronary Artery Disease
  • Prevention Measures used to prevent other blood vessel (vascular) diseases, such as coronary artery disease, may decrease the risk of retinal artery occlusion.[njretina.com]
  • Measures used to prevent other blood vessel (vascular) diseases, such as coronary artery disease, may decrease the risk of retinal artery occlusion.[gulfcoastretina.com]
  • The same measures used to prevent other blood vessel diseases, such as coronary artery disease, may decrease the risk of retinal vein occlusion.[southernutahretina.com]
  • High serum levels of uric acid also predict severity of coronary artery disease in nondiabetic, nonhypertensive patients with acute coronary syndrome [ 6 ].[omicsonline.org]
  • Measures used to prevent other blood vessel (vascular) diseases, such as coronary artery disease, may decrease the risk for retinal artery occlusion.[medlineplus.gov]
Asymptomatic
  • Prepapillary arterial loops are rare congenital vascular abnormalities, usually benign and asymptomatic. Vitreous hemorrhage and branch retinal artery occlusion (BRAO) are the most frequent described complications [ 1 , 2 , 3 , 4 ].[em-consulte.com]
  • What work-up should be done when retinal emboli are found in an asymptomatic patient? Asymptomatic retinal emboli (most often cholesterol) are found in 1 to 2% of patients older than age 50.[neuro-ophthalmology.stanford.edu]
  • It is uncertain whether the temporal arteries are more commonly affected, or if nasal branch artery obstructions are generally asymptomatic.[williamsoneyeinstitute.com]
  • Branched retinal vein occlusion (BRVO), which is more common than central retinal vein occlusion ( CRVO ), is usually asymptomatic unless the macula is involved.[amboss.com]
  • However, the evidence is limited for asymptomatic BRAO. (PPP strong recommendation) [6] Medical therapy and follow up Retinal artery occlusion is an eye emergency.[eyewiki.aao.org]
Fever
  • Temporal arteritis is an inflammatory disorder that can also produce fever, pain, or weight loss. Blood tests are ordered if temporal arteritis is suspected. Figure 1.[discoveryeye.org]
  • […] causes) include: • Carotid Artery Disease (including Carotid Dissection) • Heart Disease • Hypertension • High Cholesterol • Diabetes • Giant Cell/Temporal Arteritis (Symptoms you should ask about include: headache, jaw or shoulder pain (claudication), fever[optometrystudents.com]
Overeating
  • Risk factors for CRAO include the following: being between 60 and 65 years of age, being over the age of 40, male gender, hypertension, caucasian, smoking and diabetes mellitus.[en.wikipedia.org]
  • Over about the course of a week, the vessels reperfuse.[eyewiki.aao.org]
  • This is thought to be one of the advantages over other types of peribulbar anaesthesia, where more pronounced IOP elevation was detected [ 1 , 2 , 3 ].[karger.com]
  • Macular pucker - scar tissue on the macula Macular hole - a small break in the macula that usually happens to people over 60 Floaters - cobwebs or specks in your field of vision NIH: National Eye Institute Amaurosis fugax (Medical Encyclopedia) Central[icdlist.com]
  • As the retinal vein pressure is elevated, the retinal vein, in return, compresses the retinal artery at the reverse-crossing point, where the retinal vein crosses over the retinal artery ( B ), finally forming BRVO.[dovepress.com]
Vascular Disease
  • Prevention Measures used to prevent other blood vessel (vascular) diseases, such as coronary artery disease, may decrease the risk of retinal artery occlusion.[njretina.com]
  • If you have any type of systemic vascular disease and need to be evaluated for your risk of Retinal Vascular Disease such as Retinal Artery Occlusion, please call us to schedule an appointment Eyecare Medical Group in Portland, Maine at 888-374-2020.[eyecaremed.com]
  • Because retinal vascular diseases are common in people with high blood pressure, diabetes, and other factors that cause vascular disease, such as high cholesterol and smoking it is important to follow-up with your primary doctor to assess these factors[retinagroupflorida.com]
  • Retinal Perforations, Breaks Surgical Procedures and Postoperative Cases Toxic Retinopathies; see also Light Toxicitiy Trauma (Injury) Tumors, Neoplasma Vascular Diseases (see also: Systemic Immunologic Diseases) Acquired Macroaneurysm Arterial Obstructive[atlasophthalmology.net]
  • Measures used to prevent other blood vessel (vascular) diseases, such as coronary artery disease, may decrease the risk for retinal artery occlusion.[medlineplus.gov]
Visual Impairment
  • An abrupt blockage of blood flow (ischemia) halts proper retinal functioning, which results in visual impairment. Depending on the extent and location of the retina affected, the loss of vision may be relatively mild or very severe.[midatlanticretina.com]
  • In conclusion, occlusions of either retinal arteries or veins can cause significant visual impairment.[discoveryeye.org]
  • Impaired, Kennedy Center; University of Copenhagen; Research Centre for Prevention and Health, Glostrup Hospital; Department of Ophthalmology, Aalborg University Hospital; and Department of Ophthalmology, Odense University Hospital.[visionaware.org]
  • It is one of the more common causes of severe visual impairment in elderly patients.[patient.info]
Scotoma
  • On the 9th postoperative day visual field investigation was performed and it showed central scotoma in the RE, occupying 5 degrees (fig. 1 c). VA in the RE was unchanged.[karger.com]
  • VF was still affected with significant improvement and with residual scotoma left. On FA arterial phase was restored, OCT showed reduction of macular oedema and pale zone of the fovea has disappeared.[evrs.eu]
  • There was a superior temporal arcuate scotoma in visual field examination.[nature.com]
Retinal Pallor
  • Retinal pallor corresponds to the area supplied by the affected artery. Occasionally, an embolus (cholesterol, fibrinoplatelet, calcific) can be seen within the artery, and cotton wool spots may eventually occur around that area.[patient.info]
Unilateral Blindness
  • Symptoms: In central retinal artery occlusion, the patient generally complains of sudden, painless unilateral blindness. In branch retinal artery occlusion, the patient will notice a loss of visual acuity or visual field defects .[alpfmedical.info]
Ptosis
  • Fundoscopic exam will show a red lesion, called a "cherry red spot," with surrounding pale retina (the pale color is caused by ischemia of the retina), afferent pupil defect, periorbital eyelid edema, proptosis, ptosis, and at times a hazy/cloudy cornea[en.wikipedia.org]
Suggestibility
  • Furthermore, Gass suggested that hemorrhage could be caused by rupture of small vessels near the base of the loop caused by its movement [ 9 ].[em-consulte.com]
  • A number of observational series had suggested effectiveness in restoring retinal perfusion.[patient.info]
  • Here you can see hypoautofluorescence and thickening of the superior macula, suggestive of a branch retinal artery occlusion. Here are several line scans through the macula.[eyesteve.com]
  • Our case did not develop neovascular glaucoma; we suggest that it was because the retinal ischemia improved at an early stage. We speculate that it might have followed the mechanism shown in Figure 5.[dovepress.com]
  • However, recent studies suggest that uric acid is biologically active and can stimulate oxidative stress, endothelial dysfunction, inflammation, and vasoconstriction.[omicsonline.org]
Stroke
  • A clot in the brain may cause a stroke.[njretina.com]
  • This is similar to an ischemic stroke. Depending on how severe the clog is and how long it lasts, the retina may become permanently damaged and vision severely impaired.[retinaconsultants.net]
  • Patients should be referred to the nearest stroke center for further immediate management.[eyewiki.aao.org]
  • […] appearing gray instead of transmitting orange color of underlying choroid Interpret this finding as indication of embolism from cervical carotid artery or heart Refer to ophthalmologist urgently if vision loss came on recently Further embolization causing stroke[kellogg.umich.edu]
  • In a stroke, a small blood clot blocks the flow of blood through one of the arteries in the brain, and the area that is not getting blood becomes damaged. This same type of damage can happen anywhere in the body.[my.clevelandclinic.org]

Workup

  • Systemic workup should include an evaluation for those abnormalities associated with acute CRAO. From there your doctor will recommend a course of ocular therapy.[williamsoneyeinstitute.com]
  • The workup for BRAOs is similar to that of CRAOs, with carotid Doppler and cardiac echo to search for embolic sources.[eyesteve.com]
  • In young patients a vasculitis and/or hypercoagulable workup should be performed. In older patients, an embolic workup should be performed.[eyewiki.aao.org]
  • […] carotid disease, and other sources of emboli are classic causes of retinal ischemia (see Table 7.2). 7.1.3 Treatment of Acute Retinal Arterial Ischemia Acute treatment consists of the following: Patients seen acutely should be admitted for immediate workup[neuro-ophthalmology.stanford.edu]

Treatment

  • Several treatments may be tried. These treatments must be given within 2 – 4 hours after symptoms begin to be helpful. However, the benefit of these treatments has never been proven, and they are rarely used.[njretina.com]
  • This a treatment for CRAO that is covered by medical insurance in North America. Other treatments include ocular massage, anterior chamber paracentesis, and inhalation therapy of a mixture of 5% carbon dioxide and 95% oxygen.[en.wikipedia.org]
  • Treatment [ edit ] No proved treatment exists for branch retinal artery occlusion.[en.wikipedia.org]
  • Explore treatment videos and specific clinical cases Contact-free treatment Microsecond pulsing Focal OCT-guided treatment Retinopexy treatment Speed PRP treatment Intuitive Microsecond Pulsing Treatment - Software 3.4 Navigated non-contact PRP Iridotomy[od-os.com]
  • We also associated to this treatment: - Anticoagulant treatment; - Antifibrinolitic agents; - Treatment of the associated diseases; - Retina laser photocoagulation.[tmj.ro]

Prognosis

  • Expectations (prognosis) People with blockages of the retinal artery may not get their vision back.[njretina.com]
  • Clinical course and prognosis: The prognosis is poor because irreparable damage to the inner layers of the retina occurs within one hour. Blindness usually cannot be prevented in central retinal artery occlusion.[alpfmedical.info]
  • The prognosis is especially poor in the case of ischemic CRVO. References: [6] [7][amboss.com]
  • In general, the better the vision is at the time of diagnosis, the better the prognosis.[retinagroupofnewengland.com]
  • Prognosis The prognosis for central retinal visual acuity is poor with only about one-third of patients recovering useful vision.[medical-dictionary.thefreedictionary.com]

Etiology

  • Conclusions: Surgical embolectomy following pars plana vitrectomy is the only etiologic treatment for acute hemi-central retinal artery occlusion caused by calcific emboli.[evrs.eu]
  • Etiology: Emboli (Table 12.2) are frequently the cause of retinal artery and branch retinal artery occlusions.[alpfmedical.info]
  • The etiology of the arterial occlusion (thrombosis, embolus, arteritis, vasospasm) has also been described as affecting outcome.(4,5) Careful classification of the factors involved in an individual case of CRAO is crucial to understanding the natural[uhms.org]
  • Etiology Retinal artery occlusion Embolism Release of thrombotic emboli as a result of carotid artery atherosclerosis (most common) Emboli from the atria (usually as a result of atrial fibrillation ) Thrombosis of the retinal vessels (usually as a result[amboss.com]
  • (Etiology) The various causes that can be listed for the occurrence of Retinal Artery Occlusions include: Blood clot or embolism: The retinal arteries could be blocked by a blood clot, which obstructs the passage of blood and oxygen.[dovemed.com]

Epidemiology

  • In the rare patient who has branch retinal artery obstruction accompanied by a systemic disorder, systemic anti-coagulation may prevent further events. [1] Epidemiology [ edit ] The mean age of affected patients is 60 years.[en.wikipedia.org]
  • References: [1] [2] [3] [4] [5] Epidemiological data refers to the US, unless otherwise specified.[amboss.com]
  • Epidemiology: Retinal artery occlusions occur significantly less often than vein occlusions. Etiology: Emboli (Table 12.2) are frequently the cause of retinal artery and branch retinal artery occlusions.[alpfmedical.info]
  • Epidemiologic studies have found that uric acid can independently predict the development of hypertension, as well as stroke and heart failure [ 5 ].[omicsonline.org]
Sex distribution
Age distribution

Pathophysiology

  • Keywords: branch retinal artery occlusion, branch retinal vein occlusion, retinal vessel Background The pathophysiology of branch retinal vein occlusion (BRVO) consists of thrombosis caused by narrowing of the retinal vein at the arteriovenous crossing[dovepress.com]
  • Pathophysiology of retinal artery occlusions [ 1 ] CRAO is the ocular equivalent of cerebral stroke and is a process of end-organ ischaemia.[patient.info]

Prevention

  • Prevention Measures used to prevent other blood vessel (vascular) diseases, such as coronary artery disease, may decrease the risk of retinal artery occlusion.[njretina.com]
  • In the rare patient who has branch retinal artery obstruction accompanied by a systemic disorder, systemic anti-coagulation may prevent further events. [1] Epidemiology [ edit ] The mean age of affected patients is 60 years.[en.wikipedia.org]
  • Complications Glaucoma (CRAO only) Partial or complete loss of vision in the affected eye Stroke (due to the same factors that contribute to retinal artery occlusion, not due to the occlusion itself) Prevention Measures used to prevent other blood vessel[southernutahretina.com]
  • Prevention You may help prevent a branch retinal artery occlusion by maintaining a healthy lifestyle. Following recommendations for hypertension and diabetes will protect you further.[retinaandmacula.com]
  • What can I do to prevent retinal artery occlusion? Measures used to prevent other blood vessel (vascular) diseases, such as coronary artery disease, may decrease the risk of retinal artery occlusion.[gulfcoastretina.com]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!