Clinical features
Typically, visual loss is painless and unilateral. It may be discovered on waking. Two broad pictures are identified. In the more severe form - haemorrhagic retinopathy:
- retinal veins greatly engorged
- retinal haemorrhage with cotton wool exudates - infarcts
- severe retinal oedema from capillary closure
- optic disc swollen
- new vessel proliferation on the retina as a result of retinal ischaemia - may cause vitreous haemorrhage
In less severe cases, venous stasis occurs without capillary closure. There is some swelling of the disc with venous engorgement and oedema of the posterior pole. Haemorrhage is less conspicuous and where present, is usually peripheral. Visual loss is less severe.
Long standing ischaemia may cause neovascularisation of the iris, peripheral anterior synechiae, and secondary glaucoma.
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