Adam,Rouilly AR403 - Page 21

Condion 15
This view is of the opc disc and temporal rena
The main clinical features are:
• Papilloedema
• Tortuosity and dilataon of all branches of
the central renal vein
• Renal haemorrhages: ame shaped, dot
and blot in all quadrants
• Coon wool spots (CWS)
This diagnosis is consistent with:
CENTRAL RETINAL VEIN OCCLUSION (CRVO)
Comment:
The presence of Coon Wool Spots would suggest signicant ischaemic element. Space-
occupying lesions in the cerebrum and hyperviscosity have to be excluded. Hypertension
alone can cause Central Renal Vein Occlusion . The lesions can be beer understood by
considering that arteriolar blood is going into the rena but cannot exit through the central
opc nerve vein.
Condion 16
This view is of temporal rena and temporal opc disc
The main clinical features are:
• Aenuaon of arteries and veins
• The pale temporal edge of the opc disc is
shown
• Central ‘cherry red spot’ with surrounding
pale rena
This diagnosis is consistent with:
CENTRAL RETINAL ARTERY OCCLUSION (CRAO)
Comment:
Poor prognosis due to renal infarcon. Renal cloudiness of pale rena would disappear
aer a few weeks. Aenuated vessels would remain and consecuve opc atrophy would be
evident. The cherry-red spot is seen because the macular arterial supply from the choroid
can remain intact. Oen there is a band of neural ssue that is not rendered ischaemic by
the Central Renal Artery Occlusion, which is seen if there is an adequate cilio-renal artery
supply. This would supply the axons from the fovea centralis renal receptors to the opc
disc.
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