Obstruction of the retinal vascular lumen by an embolus, thrombus or inflammatory/ traumatic vessel wall damage or spasm. Giant cell arteritis may also be associated with this condition
The risk factors
are similar to ischemic stroke and include several modifiable risk factors:
Older age
Male gender
Smoking
Hypertension
Obesity
Diabetes
Hyperlipidemia
Cardiovascular disease
Coagulopathy
Symptoms
sudden, painless, vision loss that occurs over seconds.
Visual acuity may vary depending on the location of the obstruction.
Complete vision loss to no light perception should raise suspicion of an ophthalmic artery occlusion.
central retinal artery occlusion (CRAO)
complain of visual loss over the entire field of vision
branch retinal artery occlusion (BRAO)
complain of hemifield defect
patient with cilioretinal artery sparing may have 20/20 vision
Visual loss may have been preceded by transient loss of vision in the past (amaurosis fugax) in the case of embolic sources
Management
Retinal artery occlusion is an eye emergency. Patients should be referred to the nearest stroke center for further immediate management.