Central Retinal Artery Occlusion (CRAO)
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- Central Retinal Artery Occlusion (CRAO) is an acute ischemic event that presents with a unilateral painless complete vision loss. Unlike amaurosis fugax which is temporary, CRAO leads to permanent vision loss. The most common etiologies are thromboembolic event and giant cell arteritis (GCA).
- CRAO is analogous to a cerebral vascular accident (CVA), or a stroke, involving the retina. Workup for CRAO is very similar to the workup for stroke or transient ischemic attacks. Almost always, GCA needs to be ruled out as a cause of CRAO.
- More information at Eyewiki page
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CRAO in right eye of a 82 year old female that presented with a complete vision loss since last night. Presenting BCVA was Hand Motion (HM).
In the acute setting, there is hyperreflectivity and thickening of the inner retinal layers due to infarction/necrosis of those layers. The choroid and outter retinal layers are not affected due to a different blood supply.
Compare to the unaffected, left eye:
A cherry-red spot in the macula is seen on the initial presentation: