Central retinal artery

A variety of disorders may lead to rapid, painless, monocular or binocular vision loss. This may include central retinal artery occlusion, acute narrow-angle glaucoma, trauma, or others. The differential diagnosis is complex and needs to be undertaken by an emergency department or ophthalmologist.9... 

Central retinal artery occlusion has previously been reported in cases of intravenous and intranasal cocaine abuse and has also been reported in a man who smoked crack cocaine (166). 

Michaelides M, Larkin G. Cocaine-associated central retinal artery occlusion in a young man. Eye 2002 16(6) 790-2. 

Central retinal artery/vein occlusion Optic atrophy... 

Blood is supplied to the retina by the central retinal artery and choroidal blood vessels (Oyster, 1999). The central retinal artery arises from the ophthalmic artery, w hich in turn branches off the internal carotid artery. Upon entering the retina, the central retinal artery branches into deep capillary beds in the INL and superficial capillary beds in the GCL. Endothelial cells of retinal capillaries are joined by tight junctions, contributing to the blood/retinal barrier. There is litde or no autonomic regulation of the retinal circulation blood flow through these capillaries is instead primarily controlled by autoregulation (Wangsa-Wirawan and Linsenmeier, 2003). Retinal capillaries drain into the central retinal vein. 

Maaranen TH, Mantyjarvi MI. Central retinal artery occln-sion after a local anesthetic with adrenaline on nasal mucosa. J Neuroophthalmol 2000 20(4) 234-5. 

More selective application of thrombolysis has been attempted with injection of urokinase into the ophthalmic artery. Paques et al. (45) reported retrospectively on 26 eyes treated in this method, nine of which were combined central retinal artery occlusion (CRAO) and CRVO. The visual acuity improved significantly in only six... 

Cardiovascular Transient central retinal artery occlusion has been reported after peribulbar anesthesia [30 ]. 

Similar cases of central retinal artery occlusion after peribulbar block have previously been reported [31 ], and it has been... 

Ascaso FJ. Transient central retinal artery occlusion following peribulbar anesthesia for pars plana vitrectomy. J Clin Anesth 2010 22 577-8. 

Calenda E, Rey N, Compere V, Muraine M. Peribulbar anesthesia leading to central retinal artery occlusion. J Clin Anesth 2009 21 311-2. 

Vinerovsky A, Rath EZ, Rehany U, Rumelt S. Central retinal artery occlusion after peribulbar anesthesia. J Cataract Refract Surg 2004 30 913-5. 

The intraconal space is defined by the rectus muscles and their intercormecting septa. It contains the optic nerve, motor nerves, some blood vessels, and intraconal orbital fat tissue. Among the intraconal blood vessels, the ophthalmic artery, which branches off from the intracranial internal carotid artery, enters through the optic foramen. Near the orbital apex, the central retinal artery takes off from the ophthalmic artery and runs caudal to the optic nerve, whose dura mater it usually enters approximately 1 cm dorsal to the eyeball. 

Cardiovascular Three cases of central retinal artery occlusion after surgery with peribulbar anesthesia have been reported [47 ]. In two cases ropivacaine 0.75% (17 and 13 ml) was used in the third case the block was done with 14 ml of 2% mepivacaine. The authors suggested that these cases might be related to raised intraocular pressure due to the block or vasoconstriction caused by the local anesthetics. 

Injected autologous fat was associated with worse final best-corrected visual acuity than the other materials. All patients with ophthalmic artery occlusion had ocular pain and no improvement in best-corrected visual acuity. Optical coherence tomography revealed thinner and less vascular choroids in eyes with ophthalmic artery occlusion than in adjacent normal eyes. Concomitant brain infarction developed in 2 cases each of central retinal artery occlusion and ophthalmic artery occlusion. Phthisis developed in 1 case of ophthalmic artery occlusion. 

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