Central Retinal Artery Occlusion: Free MSRA Podcast Podcast Por arte de portada

Central Retinal Artery Occlusion: Free MSRA Podcast

Central Retinal Artery Occlusion: Free MSRA Podcast

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 🩺 Central Retinal Artery Occlusion (CRAO): MSRA Deep Dive 🚨 📝 DefinitionCRAO = sudden, complete blockage of the main artery supplying the retina.Results in abrupt, painless, usually severe vision loss in one eye.True ophthalmic emergency: time is vision! 🔥 Causes & Risk FactorsAtherosclerosis (fatty plaques in arteries) 🧱Embolism/Thrombus (clot, debris) 🩸 (often from carotid arteries, heart: AFib, valve disease)Giant Cell (Temporal) Arteritis in >50s 🧑‍🦳Vasculitis & hypercoagulable statesModifiable Risks: Age, hypertension, diabetes, high cholesterol, smoking 🚬, CVD, previous emboli, AFib 🚨 Classic PresentationSudden, painless, profound vision loss (“curtain falling”) in ONE eye 👁️Relative afferent pupillary defect (RAPD)On fundoscopy:Pale retinaCherry-red spot at macula 🍒Visual acuity: counting fingers or worse in ~94%Sometimes preceding amaurosis fugax (transient vision blackout) 🔍 PathophysiologyEmbolus or thrombosis blocks the central retinal artery ➡️ retina starved of oxygen ➡️ rapid, irreversible cell death unless treated within ~90 minutes. 🧩 Differential DiagnosisBranch Retinal Artery Occlusion (BRAO)Retinal detachmentAcute angle-closure glaucomaOptic neuritisStroke/TIAOcular migraine(Mnemonic: BROGO – Branch, Retinal detachment, Optic neuritis, Glaucoma, Others) 👨‍⚕️ DiagnosisClinical exam: Sudden, painless loss, RAPD, cherry-red spotFundoscopy: Pale retina, cherry-red spotOCT & Fluorescein angiography: Confirm and document changesCarotid Doppler/heart echo: Look for source of embolusBloods: FBC, ESR/CRP (GCA!), glucose, lipids, clotting screen ⚡️ Immediate ManagementOphthalmology emergency!Acute (within hours, weak evidence):Ocular massage 👋Lower IOP: acetazolamide IV, paracentesisInhaled carbogen, rebreathing bag, or hyperbaric O₂Thrombolysis (specialist only, rare)If GCA suspected: urgent steroids!Address underlying risk: blood pressure, glucose, cholesterol, AFib, stop smoking 🔄 Long-term ManagementAggressive cardiovascular risk reduction: Statin, aspirin/antiplatelet, antihypertensivesInvestigate carotid stenosis (consider endarterectomy)Monitor for complications:Neovascular glaucomaPermanent vision loss (most cases)Vision rehab: Low vision aids, supportDVLA: Driving advice/reporting ⏳ PrognosisVision rarely recovers (only ~1–8% regain near-normal vision)CRAO is a red flag for future stroke – treat as a systemic vascular event!Mortal risk ↑ (3x) if emboli seen 💥 ComplicationsPermanent, severe monocular blindnessNeovascular glaucoma (painful, late complication)Psychosocial impact: Depression, daily life changes 📚 MSRA Revision Resources📝 Revision Noteshttps://www.passthemsra.com/topic/central-retinal-artery-occlusion-revision-notes/🃏 Flashcardshttps://www.passthemsra.com/topic/central-retinal-artery-occlusion-flashcards/📚 Accordion Q&A Noteshttps://www.passthemsra.com/topic/central-retinal-artery-occlusion-accordion-qa-notes/🎯 Rapid Fire Quizhttps://www.passthemsra.com/topic/central-retinal-artery-occlusion-rapid-quiz/🎓 More Free MSRA Resourceshttps://www.passthemsra.comhttps://www.freemsra.com🚦 KEY TAKEAWAYSSudden, painless, severe monocular vision loss = CRAO until proven otherwise!Time is vision! Refer immediately; act fastTreat underlying cardiovascular risk – save eyes, save lives. #MSRA#Ophthalmology #CRAO #CherryRedSpot #VisionLoss #OphthalmicEmergency#MSRARevision #PasstheMSRA #FreeMSRA 👁️‍🗨️🍒⏱️
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