partial arterial retinal occlusion

Partial Arterial Retinal Occlusion: A Sudden Vision-Threatening Condition

A partial arterial retinal occlusion, also known as branch retinal artery occlusion (BRAO), is a condition where there is a blockage or obstruction in one of the smaller arteries that supply blood to the retina. This can cause sudden and temporary vision loss in one eye.

Causes and Risk Factors

A partial arterial retinal occlusion can be caused by an embolus, which is a small piece of cholesterol or other material that blocks blood flow, or by a thrombus, which is a blood clot that forms in the artery. Other risk factors include:

• Older age
• High blood pressure
• Diabetes
• Thicker-than-normal blood
• Atherosclerotic plaques
• Endocarditis
• Fat embolism
• Atrial myxoma
• Systemic vasculitis, particularly giant cell arteritis

Symptoms

The symptoms of a partial arterial retinal occlusion can include:

• Sudden loss of vision in one eye
• Blurry or distorted vision
• Floaters or spots in the affected eye
• Eye pain or discomfort (rarely)

Treatment and Prognosis

Prompt medical attention is essential to prevent permanent vision loss. Treatment may involve medications, such as anticoagulants or antiplatelet agents, to dissolve the clot or prevent further blockage. In some cases, surgery may be necessary to restore blood flow.

The prognosis for a partial arterial retinal occlusion depends on the size of the affected artery, the duration of the occlusion, and the promptness of treatment. If treated promptly, vision loss can often be reversed or minimized.

References

• [1] A branch retinal artery occlusion (BRAO) is a partial or complete obstruction of any of the branch tributaries of the central retinal artery.
• [2] Artertic retinal arterial occlusion (RAO) is caused by giant cell arteritis while most nonartertic RAO are commonly embolic in origin.
• [3] Retinal artery occlusion occurs due to blockage of the retinal artery, often by an embolus or thrombus.

Partial Arterial Retinal Occlusion (PARO) Signs and Symptoms

A partial arterial retinal occlusion, also known as branch retinal artery occlusion (BRAO), is a blockage in one of the smaller arteries that supply blood to the retina. This condition can cause sudden vision loss or changes in one eye.

Common symptoms:

• Sudden blurring or loss of vision in part of one eye [6][7]
• Partial vision loss, which may be temporary or permanent [5]
• A "shuttering" or "flapping" effect on the retina, where blood vessels appear to be moving [4]

Types and severity:

• The symptoms can vary depending on the location and extent of the blockage. If the central retinal artery is blocked, it may cause more severe vision loss.
• A partial arterial retinal occlusion can affect different areas of the retina, leading to varying degrees of vision loss.

Important note:

• If you experience any sudden changes in your vision, seek immediate medical attention from an ophthalmologist or a hospital emergency room. Prompt treatment is essential to prevent permanent damage and vision loss.

References:

[4] - A retinal artery occlusion may have different names based on the location of the blockage. [5] - Symptoms. Retinal artery occlusion is usually associated with sudden painless loss of vision in one eye. [6] - Jan 29, 2024 — Symptoms. Sudden blurring or loss of vision may occur in: All of one eye (central retinal artery occlusion or CRAO) Part of one eye (branch ... [7] - Symptoms. Sudden blurring or loss of vision may occur in: All of one eye (central retinal artery occlusion or CRAO) Part of one eye (branch retinal artery ...

Diagnostic Tests for Partial Arterial Retinal Occlusion

Partial arterial retinal occlusion, also known as branch retinal artery occlusion (BRAO), is a condition where one or more branches of the central retinal artery are blocked. This can cause sudden visual loss in the affected eye. The following diagnostic tests may be used to confirm the diagnosis:

• Optical Coherence Tomography (OCT): This imaging test can reveal hyperreflectivity and edema of the inner retinal layers, which is characteristic of BRAO [9].
• Fluorescein Angiography: This test can show areas of non-perfusion in the retina, indicating blockage of the affected branch artery [5].
• Fundoscopy: A fundoscopic exam, also known as an eye exam with a slit lamp biomicroscope, can reveal signs of retinal ischemia and edema [10].
• Carotid Ultrasonography: This test can evaluate the carotid arteries for stenosis or occlusion, which may be contributing to the BRAO [8].

These diagnostic tests are essential in confirming the diagnosis of partial arterial retinal occlusion and guiding further management. It is crucial to seek immediate medical attention if symptoms persist or worsen.

References:

[5] by B Mac Grory · 2021 · Cited by 174 — Imaging modalities such as optical coherence tomography, optical coherence tomography angiography, or fluorescein angiography can support the diagnosis of BRAO. [8] Feb 15, 2023 — Carotid ultrasonography studies and magnetic resonance angiography may be considered to evaluate the carotid arteries for stenosis or occlusion. [9] by JI Lim · Cited by 1 — Optical coherence tomography reveals hyperreflectivity and edema of the inner retinal layers in acute stages of BRAO. [10] The main test that doctors use to diagnose retinal artery occlusion is a fundoscopic exam.

Treatment Options for Partial Arterial Retinal Occlusion

Partial arterial retinal occlusion, also known as central retinal artery occlusion (CRAO), is a serious condition that requires immediate medical attention. While there is no clinically proven treatment for CRAO, various therapies have been studied to protect vision.

• Anti-VEGF injections: These injections can help reduce fluid buildup in the retina and improve vision.
• Steroid injections: Steroids can be used to reduce inflammation and swelling in the retina.
• Panretinal photocoagulation (PRP): This laser treatment can help reduce ischemia and promote healing in the retina.
• Vitrectomy surgery: In some cases, surgical removal of the vitreous gel may be necessary to restore vision.

Medications to Manage Risk Factors

In addition to these treatments, medications such as aspirin or other anti-clotting drugs may be used to manage risk factors and prevent further occlusions. Hyperbaric oxygen therapy and clot-busting medicines are also being studied as potential treatments for CRAO.

• Carbogen inhalation: This treatment involves inhaling a mixture of 95% oxygen and 5% carbon dioxide to help widen the arteries of the retina.
• Acetazolamide infusion: This medication can help reduce fluid buildup in the retina and improve vision.
• Glyceryl trinitrate (GTN) vasodilators: These medications can help widen the arteries of the retina and improve blood flow.

Important Note

It's essential to seek immediate medical attention if you or someone you know is experiencing symptoms of CRAO, such as sudden and profound visual loss. While these treatments may be used to manage the condition, they should only be administered by a qualified healthcare professional.

References:

• [2] Cugati S (2013) - Various therapies have been studied with the goal of protecting vision.
• [9] Mac Grory B (2020) - A variety of therapies have been studied with the goal of protecting vision including anterior chamber paracentesis, hyperbaric oxygen, acetazolamide therapy, ...
• [8] - Several therapies may be used including: Hyperventilation—inhaling carbogen, a mixture of 95% oxygen and 5% carbon dioxide.
• [11] - Having a drug given through a blood vessel (infusion) to break up clots.

Differential Diagnosis of Partial Arterial Retinal Occlusion

Partial arterial retinal occlusion, also known as branch retinal artery occlusion (BRAO), is a condition where there is a blockage or obstruction of one of the branch arteries that supply blood to the retina. The differential diagnosis for BRAO involves ruling out other conditions that may present with similar symptoms.

Possible Causes:

• Acute angle-closure glaucoma: This is a medical emergency that can cause sudden and severe eye pain, blurred vision, and redness of the eye.
• Central retinal artery occlusion (CRAO): While CRAO typically presents with complete obstruction of the central retinal artery, it's essential to consider this condition in the differential diagnosis of partial arterial retinal occlusion.
• Giant cell arteritis: This is a rare cause of arterial occlusion that requires prompt diagnosis and treatment.
• Embolism or thrombosis: These are possible causes of retinal artery occlusion, which can be due to emboli from the carotid artery, aortic arch, or heart.

Key Points:

• The differential diagnosis for partial arterial retinal occlusion involves ruling out other conditions that may present with similar symptoms.
• Acute angle-closure glaucoma and central retinal artery occlusion are two possible causes to consider in the differential diagnosis.
• Giant cell arteritis is a rare but important cause of arterial occlusion that requires prompt diagnosis and treatment.

References:

• [1] Sharma Y, Bypareddy R. Acute vision loss due to central retinal arterial occlusion, partial optic nerve. (Context 3)
• [2] Retinal artery occlusion refers to blockage of the retinal artery carrying oxygen to the nerve cells in the retina at the back of the eye. (Context 6)
• [3] Central retinal artery occlusion is a blockage of the central retinal artery. The blockage often comes from a blood clot or cholesterol in the artery. (Context 12)