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Branch Retinal Artery Occlusion (BRAO)

Acute, painless, partial or complete loss of vision

Condition


BRAO is a blockage of one of the arteries in the retina and poses significant risks to vision. The most common causes of BRAO include cholesterol emboli from aorto-carotid atheromatous plaques, platelet-fibrin emboli from thrombotic disease (blood clot), and calcific emboli from cardiac valvular disease.

Risk factors


Risk factors for a BRAO include high blood pressure, smoking, diabetes, high cholesterol, coronary artery disease, heart valve problems, intravenous drug abuse, atrial fibrillation, or history of stroke or transient ischemic attack (TIA). Having a family history of blood clots or clotting disorder also increases your risk.

Symptoms


Symptoms of a branch retinal artery occlusion include acute painless loss of vision or blurring in one eye. Vision loss may be complete or partial.  Some patients may experience brief episodes (1-10 minutes) of vision loss known as amaurosis fugax prior to developing a BRAO, and some patients may be asymptomatic.

Treatment


Following a BRAO, vision can range from normal to extremely limited. If you have had a BRAO, regular visits with your ophthalmologist are essential.  Rarely, patients can develop neovascularization which leads to further vision loss and possibly glaucoma.  Depending on your age, a focused work up will be performed to identify risk factors and find the cause (which can be identified in 90% of patients).  Managing the cause, either medical or surgical, as well as controlling the factors causing the condition can lessen the chances of BRAO recurring, worsening over time, or of having a stroke.  Working with your general practitioner or cardiologist to best control any risk factors you may have can help to reduce the risk of a BRAO.

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