Central Retinal Artery Occlusion Definition, Reason, Symptoms, Treatment & Prevention
Understanding
Retinal artery occlusion ( Central Retinal Artery Occlusion / CRAO) is an eye disease characterized by sudden blockage of the retinal arteries.
The retina is a thin layer at the back of the eye which has the role of converting light into nerve signals so that it can be ‘read’ by the brain. In the retina, there are two main blood vessels, namely the central retinal artery and Central Retinal Artery Occlusion. These two blood vessels function to supply oxygen and nutrients so that the retina can carry out its duties properly.
In impaired retinal artery occlusion, due to a sudden blockage in the artery, the sufferer’s vision will suddenly decrease.
Retinal artery occlusion disease is more common in men than women. Generally, sufferers aged 40 years and over.
Symptoms
The main symptom of retinal artery occlusion is a sudden decrease in visual acuity. But usually, this only occurs on one side of the eye. This visual disturbance is not accompanied by complaints of itching or pain.
Visual disturbances that occur are usually quite severe. Even sufferers can be unable to read letters at all, even though the letters written are quite large.
Patients with retinal artery occlusion must be aware of sudden blockages in other organs. For example, a sudden blockage in the heart (causing a heart attack), or a sudden blockage in the brain (causing a stroke). It is not uncommon for a few days after a retinal artery occlusion occurs, the sufferer has a heart attack.
Reason
Retinal artery occlusion can be caused by various things, including:
- Uncontrolled hypertension
- Diabetes mellitus
- Heart valve disease
- Congenital heart disease
- Injecting drug user
- Conditions where the blood thickens ( hypercoagulable state ), for example in users of oral contraceptives, sufferers of polycythemia, or antiphospholipid syndrome (Hughes syndrome)
Diagnosis
Determination of the diagnosis of retinal artery occlusion can be confirmed by an ophthalmologist. If there is a suspicion of this disorder being found, the doctor will conduct an examination to see the condition of the retina using a funduscopic device. This tool is shaped like a small flashlight to see the depth of the retina.
In addition, sometimes an optical coherence tomography (OCT) examination is also needed to see the condition of the retinal layers in detail. To confirm the diagnosis, the doctor will also check blood sugar, blood cholesterol, blood pressure, and echocardiography to determine the cause of retinal artery occlusion.
Treatment
Until now, the right treatment to restore vision after retinal artery occlusion is still in the research stage. There are several treatment options that are generally performed, namely:
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Eyeball massage
This action is performed by pressing on the eyeball for 5–15 seconds, then releasing the pressure. This can be repeated several times. This action aims to release the arterial blockage that occurs.
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Paracentesis
Paracentesis is the act of removing some of the fluid in the eyeball. This action is performed using a syringe. In order not to cause pain, the eye will be dripped with anesthetic before the procedure is performed.
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Drugs
Medicines to lower eye pressure can also be given. For example acetazolamide, or other diuretic drugs.
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Laser Nd: YAG
Nd: YAG lasers can help to destroy blocked retinal arteries. If done quickly, this action can improve vision. However, this laser also has complications such as the formation of aneurysms and vitreous hemorrhage.
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Hyperbaric therapy
Hyperbaric therapy is given by delivering 100 percent oxygen at high pressure. This therapy is useful for retinal artery occlusion that occurs less than 12 hours. If it has been going on for more than 12 hours, this treatment is no longer effective.
To get maximum treatment and monitoring, generally, people with retinal artery occlusion require hospitalization for several days.
Prevention
To prevent retinal artery occlusion, efforts that can be made are:
- keeping blood pressure under control (below 140/90 mmHg)
- maintain LDL cholesterol
- eat foods high in fiber and low in fat
- exercise regularly
- if you have diabetes, then the patient must routinely take medication and carry out routine controls to the doctor so that blood sugar is monitored