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Retinal Artery Occlusion Workup

  • Author: Benjamin Feldman, MD; Chief Editor: Robert E O'Connor, MD, MPH  more...
 
Updated: Dec 14, 2015
 

Laboratory Studies

Laboratory studies are helpful in determining the etiology of central retinal artery occlusion (CRAO) but do not affect ED treatment.

Obtain a CBC to evaluate anemia, polycythemia, and platelet disorders.

Sickle cell disease may case RAO in black patients and may warrant additional studies.

Evaluate the erythrocyte sedimentation rate (ESR) for inflammatory endarteritis in the absence of another etiology.

Measure fibrinogen level, antiphospholipid antibodies, prothrombin time (PT), activated partial thromboplastin time (aPTT), and serum protein to evaluate for coagulopathies.

Obtain cholesterol, triglycerides, and lipid panel to evaluate for atherosclerotic disease.

Evaluate blood cultures for bacterial endocarditis and septic emboli.

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Imaging Studies

Imaging studies are helpful in determining the etiology of CRAO but do not affect ED treatment.

Echocardiogram is not necessarily an ED test, but it can be used to evaluate valvular disease, wall motion abnormalities, mural thrombi, and vegetations that may cause septic emboli.

Carotid Doppler ultrasound can be used to evaluate atherosclerotic disease, although a magnetic resonance angiogram may be more accurate in detecting obstruction.

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Other Tests

Perform an ECG to evaluate for possible atrial fibrillation (24-hour Holter monitor may be necessary if arrhythmia is suspected but not detected on ECG testing).

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Procedures

See Treatment below for massage and paracentesis.

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Contributor Information and Disclosures
Author

Benjamin Feldman, MD Resident Physician, Department of Emergency Medicine, University of California, Irvine, School of Medicine

Benjamin Feldman, MD is a member of the following medical societies: American Academy of Emergency Medicine, Emergency Medicine Residents' Association

Disclosure: Nothing to disclose.

Coauthor(s)

Pascal SC Juang, MD Medical Director, ED Information Systems, Department of Emergency Medicine, Hoag Memorial Hospital Presbyterian

Pascal SC Juang, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Douglas Lavenburg, MD Clinical Professor, Department of Emergency Medicine, Christiana Care Health Systems

Douglas Lavenburg, MD is a member of the following medical societies: American Society of Cataract and Refractive Surgery

Disclosure: Nothing to disclose.

Chief Editor

Robert E O'Connor, MD, MPH Professor and Chair, Department of Emergency Medicine, University of Virginia Health System

Robert E O'Connor, MD, MPH is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Association for Physician Leadership, American Heart Association, Medical Society of Delaware, Society for Academic Emergency Medicine, Wilderness Medical Society, American Medical Association, National Association of EMS Physicians

Disclosure: Nothing to disclose.

Additional Contributors

Assaad J Sayah, MD, FACEP Chief, Department of Emergency Medicine; Senior Vice President, Primary and Emergency Care, Cambridge Health Alliance

Assaad J Sayah, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians, Massachusetts Medical Society, National Association of EMS Physicians

Disclosure: Nothing to disclose.

Neil Jain, MD Staff Physician, Yale University School of Medicine, Department of Surgery, Section of Emergency Medicine

Neil Jain, MD is a member of the following medical societies: American College of Emergency Physicians, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Acknowledgements

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous authors, Kilbourn Gordon III, MD, and Enoch Huang, MD, to the development and writing of this article.

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The cherry red spot of central retinal artery occlusion.
 
 
 
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