Retinal Embolism

DEFINITION: There is a wide-ranging vascular system consisting of arteries and veins in the retina. Obstruction in veins of the retina is called retinal vein obstruction, while obstruction in arteries of the retina is called retinal arterial obstruction.

Figure 1. Fundus photography of a patient diagnosed with branch retinal vein occlusion (left). Fundus photography of a patient who received argon laser photocoagulation treatment for branch retinal vein occlusion at our hospital.

RISK FACTORS AND CAUSES: Retinal vein obstructions mostly occur between the ages of 50 and 60. Patients with hypertension, arteriosclerosis, coagulation problems, and diabetes are at risk. Retinal artery obstructions are generally caused by a minor embolus (coagulum) in the blood circulation. High blood and cholesterol values, cardiac diseases, arteriosclerosis, systemic hypertension and diabetes are among the risk factors for retinal arterial obstruction.

Figure 2. Fundus appearance of central retinal vein occlusion (left) and branch retinal artery occlusion (right).

FINDINGS: Sudden and painless loss of vision emerges in both obstruction types.

DIAGNOSTIC TESTS: In biomicroscopic visual examination, bleeding in retinal layers, intra-retinal fluid accumulations and intra-retinal substance accumulations are found in retinal vein obstructions, while paleness and edema can be found in the retinal obstruction area in retinal arterial obstructions. For making the diagnosis and detecting the damage, retinal angiography and retinal tomography can be carried out. Blood tests and internal diseases and cardiology consultation may be required to evaluate the risk factors and Doppler ultrasonography to evaluate constrictions in the vessels of the neck.

TREATMENT: If the patient comes earlier than 6-8 hours before the destruction of retinal cells at an early stage in arterial obstruction, this obstruction may be eliminated by creating a sudden decrease in intraocular pressure through different methods (anterior chamber paracentesis, medications lowering the intraocular presuure, eye massage). Again at an early period, an increase in vision can be achieved, although small, through hypobaric oxygen treatment. In vein obstructions, intraocular medication injections, laser photocoagulation treatments and sometimes surgical operations may be required according to the condition of the patient. Patients should be followed-up for the treatment of underlying risk factors and potential eye complications such as glaucoma.

Figure 3. Fundus photography of a patient diagnosed with central retinal artery occlusion (right) and healthy other eye of the same patient (left).