Central Retinal Artery Occlusion: Pathogenesis and clinical findings • Inflammatory Disease: (i.e. GCA, SLE, GPA) -> Endothelial cell damage creates hypercoagulable state • Cardiogenic Embolism: (i.e. Valvular, arrhythmias, congenital defects) -> Abnormal blood flow causing localized stasis • Hypercoagulable state: (i.e. OCP, Protein C & S deficiency, ATIII deficiency) -> Increased coagulation and/or decreased anti-coagulation • Hematologic Disease: (i.e. leukemia/lymphoma, sickle cell, polycythemia) -> Increased blood viscosity and inflammation • Carotid Artery Atherosclerosis -> Atherosclerotic plaque dislodges from carotid artery => Blockage of central retinal artery => Central Retinal Artery Occlusion (CRAO) • The retina becomes pale from perfusion -> The choroidal vessels supplying the macula via the posterior ciliary artery become more prominent within a background of retinal pallor -> Cherry-red spot • Decreased perfusion of retinal arterioles due to upstream CRAO -> Arteriole narrowing • Slow retinal artery blood flow allows for segmentation of the blood column -> "Box-carring" or "cattle trucking" • Acute retinal edema caused by ischemia results in a blurred appearance of the retina -> Ground Glass Retina • Ganglion cells and axons death due to ischemia results in disc pallor seen months after CRAO -> Pale Optic Disc -> Decreased Visual Acuity #CentralRetinalArtery #Occlusion #CRAO #pathophysiology #ophthalmology #diagnosis #signs #symptoms
