Retinal artery occlusion
| Classification according to ICD-10 | |
|---|---|
| H34 | Retinal vascular occlusion |
| G45.3 | Amaurosis fugax |
| ICD-10 online (WHO version 2019) | |
With retinal artery occlusion, the central artery of the retina ( arteria centralis retinae ) of the eye closes. A lack of oxygen in the retina follows . The symptom is sudden painless blindness in one eye approximately 30 seconds after the occlusion event. The cause of the occlusion is a blood clot ( embolism ) that has washed in , which usually originates from a cervical artery or is caused by an atrial thrombus as part of cardiac arrhythmias . After 60 to 90 minutes, permanent retinal damage occurs. The examination shows almost complete loss of vision, a lack of pupil reflex and a white-gray discoloration of the non-perfused retinal sections in the fundus . Treatment attempts with massage of the eyeball to dissolve the embolus , anticoagulant and lowering of intraocular pressure are undertaken. The prognosis is still bad. Spontaneous improvements only occur if the closure is incomplete.
A short-term retinal artery occlusion with complete regression of blindness within minutes is known as amaurosis fugax (Latin for volatile blindness). It is often considered the first sign of a cerebral circulatory disorder and can also occur in connection with a carotid stenosis .
The risk factors of vascular events in the eye correspond to those of embolism and arteriosclerosis in general, i.e. arterial hypertension , diabetes mellitus and heart valve vitia . Then there is the ipsilateral carotid stenosis .
Giant cell arteritis , also known as Horton's disease, is particularly important aetiologically for both diagnoses . If there is any suspicion, it is essential to act quickly as a stroke and loss of the other eye must be feared. In this case, high doses of cortisone are administered immediately, even without final confirmation . It is therefore particularly important to pay particular attention to the presence of this etiology .
literature
- Axenfeld / Pau: textbook and atlas of ophthalmology . With the collaboration of R. Sachsenweger u. a., Stuttgart: Gustav Fischer Verlag, 1980, ISBN 3-437-00255-4
Individual evidence
- ^ Albert J. Augustin: Ophthalmology . Berlin: Springer Verlag, 2007, p. 147. ISBN 978-3-540-30454-8
