Retinal Artery Occlusion Workup

  • Author: Neil Jain, MD; Chief Editor: Robert E O'Connor, MD, MPH   more...
 
Updated: Apr 13, 2012
 

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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Proceed to Treatment & Management
 
 
Contributor Information and Disclosures
Author

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 and Society for Academic Emergency Medicine

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 and American College of Emergency Physicians

Disclosure: Nothing to disclose.

Specialty Editor Board

Assaad J Sayah, MD  Chief, Department of Emergency Medicine, Cambridge Health Alliance

Assaad J Sayah, MD is a member of the following medical societies: National Association of EMS Physicians

Disclosure: Nothing to disclose.

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

Disclosure: Medscape Salary Employment

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.

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

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 College of Physician Executives, American Heart Association, American Medical Association, Medical Society of Delaware, National Association of EMS Physicians, Society for Academic Emergency Medicine, and Wilderness Medical Society

Disclosure: Nothing to disclose.

Additional Contributors

The authors and editors of eMedicine 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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