Retinal Artery Occlusion | Causes, Symptoms, and Treatment

When you hear the word “stroke,” you probably think of a brain stroke that happens when a blood vessel in or around the brain ruptures, or when a blood clot blocks blood flow to the brain. But have you ever heard of a stroke in the eye, known as retinal artery occlusion?

“Eye stroke” is a term used to describe conditions that cause vision loss due to reduced blood flow to the eye. This can occur when there is a blockage in the arteries or veins that supply the retina with blood; this is what we call retinal artery occlusion.

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What Is Retinal Artery Occlusion?

Central retinal artery occlusion (CRAO) is an ophthalmic emergency. It is one of the most common causes of severe vision loss in older adults. To understand how it presents and what it does, it’s important to know how blood flows to the retina. The retina receives its blood supply from two main sources:

Depending on where the occlusion occurs, different layers and quadrants of the retina can be affected. The more proximal (closer to the origin) the occlusion is in the ophthalmic artery, the more devastating the impact will be, because all retinal layers lose their blood supply. In contrast, an occlusion in a small, distal branch of the retinal artery will affect only the inner neurosensory retina in that region, sparing the photoreceptors and thereby limiting the degree of vision loss.

An occlusion involving the retinal artery before it branches is called central retinal artery occlusion (CRAO), while blockage of one of its branches is referred to as branch retinal artery occlusion (BRAO).

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Pathophysiology of Retinal Artery Occlusion

Central retinal artery occlusion (CRAO) is essentially the ocular equivalent of an ischemic stroke. It represents an end-organ ischemic event, and many of its risk factors overlap with those of cardiovascular and cerebrovascular disease. Its occurrence is a warning sign for other serious vascular complications.

In many cases, the exact underlying cause is not fully clear, but the most common etiologies are well documented. The main mechanisms include embolization, vascular occlusion, and external vascular compression.

Embolism is the most frequent cause. The primary source is usually carotid artery disease, most often due to atherosclerotic plaques. Carotid artery stenosis and certain cardiac conditions are other major sources of emboli.

Localized atherosclerotic plaques and vasculitis can lead to vessel narrowing and occlusion. Emboli (which may be calcific, thrombotic, fibrinous, bacterial, or cholesterol) typically originate from the carotid arteries or the heart. In rare cases, a mass in the posterior orbit can compress the optic nerve and central retinal artery and cause CRAO.

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Whatever eye condition or defect is present, this is a delicate medical problem that requires thorough evaluation and prompt, appropriate treatment by a skilled ophthalmologist using effective diagnostic tools and therapeutic technologies to achieve the best possible outcome. Whatever eye disease you are dealing with, you can book an appointment at Batal Specialized Medical Complex to undergo the necessary examination and start addressing your eye problems, no matter how complex they may be.

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