Inflammatory conditions like giant cell arteritis (GCA), may also cause CRAO. The embolus may be composed of cholesterol, fibrin-platelet, or calcium and usually originates from the carotid plaque and less commonly from the heart or the aorta. Central retinal artery occlusion (CRAO) - This disease entity characteristically presents as a sudden onset of painless, unilateral visual loss in elderly patients, most commonly caused by an embolism, which blocks the central retinal artery.The causes of cherry-red spot in the macula can be categorized into 6 groups, according to etiological factors: Knapp had initially believed that the cherry red spot was a benign fundoscopic finding, but later on realized its grave implications. Bernard Sachs acknowledged that his patient had also been examined by ophthalmologist Herman Joseph Knapp, who practiced in both New York and Berlin, and described the striking retinal findings at an ophthalmology meeting in Heidelberg and used the term “cherry red color” to describe the fovea. The patient was confirmed upon neuropathologic examination to have lipid storage in the brain. The term “cherry-red spot” was first introduced by American neurologist Bernard Sachs in 1887, when describing the fundus appearance of a child with "amaurotic familial idiocy" in his publication on “arrested development with special reference to its cortical pathology”. It should be noted that as a condition resolves or evolves over the course of time, the appearance of a cherry-red spot diminishes and may not be present therefore, absence of a cherry red spot does not indicate that a disease is not present. Cherry-red spot is an important fundoscopic sign, and when found with key clinical features and a good history, often guides one to the diagnosis of the disease. As ganglion cells are absent at the foveola, this area retains relative transparency and contrasts with the surrounding retina. In the case of lipid storage diseases, the lipids are stored in the ganglion cell layer of the retina, giving the retina a white appearance. The appearance of a cherry red spot can result from retinal edema most commonly due to central retinal artery occlusion or traumatic retinal ischemia, which cause the perimacular tissue of the retina to appear translucent, while the fovea maintains its normal color.
The fovea receives its blood supply from the choroid, which is supplied by the long and short posterior ciliary arteries. The fovea retains relative transparency as it is the thinnest part of the retina and is devoid of ganglion cells. The term refers to the appearance of a red-tinted region at the center of the macula surrounded by retinal opacification, and it consists a clinical sign usually present within the context of thickening and loss of transparency in the posterior pole of the retina. as well as a variety of lysosomal storage disorders. Ĭherry-red spot (CRS) at the macula is a clinically significant sign observed on fundus examination in a variety of pathological conditions, including retinal infarction, retinal ischemia. Cherry red spot in patient with central retinal artery occlusion.
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