Retinal artery occlusion is when there is a blockage of an artery supplying the retina. There are two main types: branch retinal artery occlusion and central retinal artery occlusion.
A central retinal artery occlusion involves a blockage of the main artery that supplies the retina, whereas a branch retinal artery occlusion involves a small distal artery that supplies part of the retina. In general, central retinal artery occlusion has the worse visual prognosis.
This photograph shows an example of a branch retinal artery occlusion. You can see an embolus inside the artery in this picture and distal to that, the retina has turned white from ischemia. This patient lost vision in the top part of their field of vision.
In conjunction with the patient’s primary care doctor, the cause of a branch or central retinal artery occlusion should be promptly evaluated. This may include bloodwork to exclude inflammatory conditions and/or ultrasound of the neck vessels and heart looking for any potential sources of emboli. This investigation is critical to identify any potential life-threatening causes of artery occlusion.
How Is Retinal Artery Occlusion Treated?
Treatment of artery occlusions are limited. In the office, your retina specialist may attempt a procedure to lower the eye pressure (paracentesis), may put you on pressure lowering drops, or perform ocular massage. Sometimes, if a thrombolytic (something that breaks up clot) medicine is given early enough (within hours) by an interventional radiologist, visual prognosis might be improved. Even without treatment, final vision in these eye can range from 20/20 to no light perception (NLP). There are other complications that can occur months after an artery occlusion including neovascular glaucoma. This can be treated with laser and sometimes intravitreal injection.