03-24-2007, 04:00 PM
The Diagnosis of CRAO is confirmed, what is your initial step in management?
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crao - uterus
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03-24-2007, 04:05 PM
Results of treatment is unsatisfactory.
The goal is to restore blood flow as soon as possible in all cases seen within 48 hours. This includes the following: a. supine position, helps maintain circulation b. ocular massage, intermittently for at least 15 min, to increase blood flow, decrease intraocular pressure(IOP) and possibly dislodge emboli c. decrease IOP, may perfuse the retina better and dislodge emboli. IV acetazolamide and topical beta blockers are used and sometimes anterior chamber paracentesis if needed. d. ventilation with 100% oxygen was used before but not any more because of vasoconstriction. Combination of carbon dioxide and oxygen was also tried to supply enough oxygen to the choroidal circulation to reach the inner retina, but it was also found to be toxic to the retina. e. vasodilators in the retrobulbar space can be given but not used to avoid hemorrhage f. surgical cannulation of the supraorbital artery and perfusion with heparin, papaverine or streptokinase was used in trials g. IV rt-PA was also used with variable results h. Experimental studies: ice packs and IV dextromethorphan The most serious complication of CRAO is neovascularization and the development of neovascular glaucoma which occurs in about 16% of patients and warrants treatment.
03-24-2007, 04:09 PM
triplehelix, can you plz mention the source of this info?
03-24-2007, 04:32 PM
03-24-2007, 04:37 PM
the reason I asked coz the choice D) "ventilation with 100% oxygen was used before but not any more because of vasoconstriction. Combination of carbon dioxide and oxygen was also tried to supply enough oxygen to the choroidal circulation to reach the inner retina, but it was also found to be toxic to the retina"
is absolutely different from that of UW explanation, they explain that initial steps to be taken must be ocular massasge and HIGH FLOW OXYGEN |
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