Sabtu, 28 September 2013

Central Retinal Artery Occlusion

Clinical symptoms:

The disorder is usually about one eye, and particularly the arteries at the entry area in the lamina kribrosa.1, 4.7

Complaints of patients with central retinal occlusion begins with an intermittent blurred vision (amaurosis fugaks), not accompanied by pain and then dark settled.

Or with complaints of vision suddenly dark, where these marks occur when the occlusion is only found in one of the branches in the main stem of a. Central retina but before there is a history of amaurosis fugaks without sighting abnormalities in the outer eye.

Physical examination:

Visual acuity ranged from counting fingers and light perception in 90% of eyes at the time of initial examination. Decrease in visual acuity in the form of repeated attacks can be caused by diseases of vessels spasm or embolism running. Sometimes the visual acuity to be good back when spasmenya disappeared.

Afferent pupillary defect can appear within a few seconds after blockage of retinal artery becomes weak reaction of the pupil with the pupil anisokoria. Pupillary defect is usually precede abnormalities arise fundus for one hour. On funduscopic examination will look all pale in color due to retinal edema and disruption of nutrients to the retina.

There is a picture of a sausage on retinal arteries due to retinal artery filling uneven. 25% of eyes with central retinal artery occlusion have arteries that are silioretina anastomose between a. Central retina and a. siliaris is not about the macula so that the macular region may still see it rather than central visual acuity that can still be maintained.

After several hours of the retina will appear pale, grayish turbid due to edema layer in the retina and ganglion cell layer. In this case the picture will look red cherry (cherry red spots) on the macula lutea. This is due to absence of ganglion layer in the macula, so that the macula retain its original color. Over time the color papil pale and blurred boundaries. Clinically, retinal turbidity disappeared within 4-6 weeks, leaving a pale optic disc as the first ocular findings.

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