A 64-year-old man arrives at the emergency room with painless loss of vision in his right eye. The patient's symptoms began abruptly and have persisted for several hours. He has no history of trauma or similar events. He has had coronary artery disease, atrial fibrillation, and type 2 diabetes mellitus in the past. The blood pressure is 144/86 mm Hg, and the pulse rate is 92 beats per minute. Cardiovascular examination reveals an irregularly irregular rhythm with no murmurs, no peripheral edema, and symmetrically slightly diminished pedal pulses in both feet. Visual acuity in the right eye is limited to hand motion and normal in the left. The image below depicts a funduscopic examination of the right eye. Which of the following is the most likely cause of this patient's loss of vision?

Question

Quizplus · Accepted Answer

Eductional Objective: The central retinal artery occlusion is characterized by acute and painless monocular vision loss (CRAO). Vision loss affects the entire visual field and is frequently permanent. A pale retina (due to ischemia and edema) and a cherry-red macula are among the funduscopic findings (the fovea and foveola are thin and have a separate blood supply from the choroid artery; the red choroid is easily visible underneath).
The central retinal artery is an ophthalmic artery branch that arises from the internal carotid artery. The most common causes of CRAO are atherosclerosis and thromboembolism. Atrial fibrillation and carotid artery stenosis are risk factors. Vasculitic diseases can also cause CRAO (eg, giant cell arteritis).

A 64-Year-Old Man Arrives at the Emergency Room with Painless