A patient with acute central retinal artery occlusion shows a cherry-red spot at the macula. The spot appears red because:

• A Neovascularization at the macula leaks dye that stains the foveal center
• B Extravasated blood pools at the center of the macula after the arterial occlusion
• C The ganglion cell layer at the fovea is thickest and retains its normal color
• D The fovea derives its blood supply directly from the choroid, so it remains perfused while the surrounding retina becomes opaque ✓

Explanation

The inner retina becomes milky white from ischemic opacification after central retinal artery occlusion. At the fovea the inner layers are absent and the thin center is nourished by the underlying choriocapillaris, so it stays transparent and the red choroidal vasculature shows through as the cherry-red spot. Option B fails because there is no hemorrhage in typical arterial occlusion, and option C fails because the ganglion cell layer is actually absent at the fovea, not thickened.

Reference: Kanski's Clinical Ophthalmology, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.