A 55-year-old hypertensive woman presents with sudden painless loss of vision in the left eye. Fundoscopy reveals a diffuse retinal haemorrhage in all four quadrants in a 'blood and thunder' appearance, dilated tortuous veins, disc oedema, and multiple flame-shaped haemorrhages. The most likely diagnosis is:
- A Branch retinal artery occlusion
- B Central retinal artery occlusion
- C Central retinal vein occlusion ✓
- D Vitreous haemorrhage
Correct answer: C. Central retinal vein occlusion
Explanation
Central retinal vein occlusion (CRVO) classically presents with sudden, painless vision loss and the characteristic 'blood and thunder' fundus showing flame-shaped haemorrhages in all four quadrants, dilated tortuous veins, disc oedema, and cotton wool spots. It is strongly associated with systemic hypertension and raised IOP. Macular oedema is the main cause of vision loss, and anti-VEGF injections are first-line treatment.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.