A 55-year-old hypertensive presents with sudden, painless visual loss in one eye. Fundoscopy shows diffuse retinal haemorrhages in all 4 quadrants ('blood and thunder' appearance), disc oedema, and dilated tortuous veins. FFA shows prolonged arteriovenous transit time. What is the diagnosis and preferred treatment?
- A Central retinal vein occlusion (CRVO); treated with intravitreal anti-VEGF for macular oedema ✓
- B Central retinal artery occlusion; treated with IV thrombolytics
- C Non-arteritic ischaemic optic neuropathy; treated with corticosteroids
- D Diabetic papillopathy; treated with PRP
Correct answer: A. Central retinal vein occlusion (CRVO); treated with intravitreal anti-VEGF for macular oedema
Explanation
Diffuse haemorrhages in all four quadrants, disc oedema, dilated tortuous veins, and prolonged AV transit on FFA are classic for central retinal vein occlusion (CRVO). Macular oedema from CRVO is treated with intravitreal anti-VEGF agents (ranibizumab, aflibercept) as first-line therapy per current RCT evidence (CRUISE, GALILEO, COPERNICUS trials). Neovascular complications require PRP. CRVO requires systemic investigation for hypercoagulable states, hypertension, and diabetes.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.