A 77-year-old presents with sudden visual loss. This is consistent with which diagnosis?
Analysis
There is significant inner retinal swelling and hyperreflectivity. This includes the NFL, GCL, and inner plexiform. There is sharp demarcation of the inner from the outer half of the retina. Also present is significant shadowing of the deeper retina, with the exception of the fovea. This patent had significant signal attenuation of the deep capillary plexus on OCTA and the presence of cloudy swelling with a cherry red spot on clinical exam (video).
The patient was diagnosed with central retinal artery occlusion.
In this tip's accompanying 9 min. video, we'll:
- Review the pathogenesis of CRAO
- Learn systemic causes
- Review how CRVO and CRAO present differentially on OCT
OCT Tip
Inner retinal hyperreflectivity, especially when associated with a normal RPE in the fovea but shadowing of the peritoneal area is a CRAO until proven otherwise.
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