A 62-year-old man presents with sudden, painless, complete loss of vision in one eye. Fundoscopy reveals a pale, oedematous retina with a cherry-red spot at the fovea. The optic disc appears normal. The most likely diagnosis and the vessel involved are:

• A Central retinal vein occlusion; central retinal vein
• B Anterior ischaemic optic neuropathy; posterior ciliary artery
• C Vitreous haemorrhage; retinal neovascularisation
• D Central retinal artery occlusion; central retinal artery ✓

Explanation

Central retinal artery occlusion (CRAO) presents with sudden, complete, painless monocular blindness. The ischaemic inner retina becomes pale and oedematous, but the fovea (avascular zone supplied by choroidal circulation via RPE) retains its reddish colour, creating the classic cherry-red spot. The central retinal artery, a branch of the ophthalmic artery, is occluded, typically by an embolus from the carotid artery. CRAO is an ocular emergency analogous to stroke.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.