Retinal Artery Detachment

 Retinal Artery Detachment

Retinal artery occlusion is blockage of blood supply in arteries to retina light sensitive tissue in back of eye.

Retinal arteries become blocked by blood clot or substances (fat or plaque) get stuck in arteries.

Blockages occur due to hardening of arteries in eye.

Diagnostic Evaluation

1. Color vision

2. Examination of retina after pupil dilated

3. Fluorescein angiography; to look blood flow in retina and choroid 

4. Intraocular pressure

5. Pupil reflex response

6. Retraction test

7. Retinal photography

8. Slit lamp examination

9. Testing of side vision (visual field examination)

10. Tests measures electrical activity of retina

11. Visual acuity

Test to identify other part of body.

1. Echocardiogram

2. Heart monitor for abnormal heart rhythm

3. Ultrasound or Doppler ultrasound of carotid arteries

4. Blood pressure

5. Cholesterol and triglyceride level

6. Complete physical exam

Management

Immediately lower of IOP to target pressure of 15mmHg.

1. Ocular massage

Apply direct pressure for 5-15 sec then release; improves retinal perfusion.

2. Anterior chamber paracentesis

Slit lamp removal of 0.1-0.4ml of aqueous humor via tuberculin syringe at 27G needle may decrease IOP to 3mmHg. Decrease IOP allow perfusion.

3. Medication 

1. Carbonic Anhydrase inhibitors

Inhibit CA (carbonic anhydrase) in ciliary processes of eye.

Decrease aqueous humor secretion

Reducing IOP

2. Sympathomimetics

Lower IOP by increase outflow and reducing production of aqueous humor.

3. Beta-adrenergic blocking agent

Lower IOP by decreasing rate of aqueous humor production.