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Ophthalmology and Visual Sciences

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Central Retinal Artery Occlusion (CRAO)

Contributor: Thomas A. Weingeist, PhD, MD, University of Iowa

Updated and Expanded by: Cameron Wagner, BS  and Lorraine M. Provencher, MD

Central retinal artery occlusion (CRAO) occurs when occlusion of the central retinal artery, a branch of the ophthalmic artery, results in infarction of the inner retina with subsequent, typically severe, vision loss. The picture above exhibits a CRAO with sparing of the foveal retina due to the presence of a cilioretinal artery. A cilioretinal artery has been found to be present in 49.5% of patients. The cilioretinal artery branches off the ophthalmic artery and supplies the inner retina in these individuals. This is in contradistinction to the posterior ciliary arteries, which branch off the ophthalmic artery and supply the choroid and outer retina. Patients with a cilioretinal artery may have preserved central vision in the unfortunate event of a CRAO.

CRAO

Image Caption: Sparing of the fovea due to a ciliary retinal artery in the presence of a CRAO secondary to a cardiac myxoma.


Contributor: David Phillips, MD

Photographer: Andrea Starkweather

This middle-aged male presented with an abrupt decrease in vision in the right eye 4 days prior. Note the retinal whitening, classic cherry red spot, and scatted cotton wool spots. The OCT shows inner retinal edema in the right eye (OD) compared to the normal retinal OCT in the left (OS). Also note the delayed filling of the macular arteries on the fluorescein angiogram.

Right Eye

OCT
Right Eye Left Eye
Right Eye Showing inner retinal edema Left eye showing normal OCT

fluorescein angiograph showing delayed filling


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Ophthalmic Atlas Images by EyeRounds.org, The University of Iowa are licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.

last updated: 03/24/2017; originally posted 02/08/2008 and 10/23/2014