Retinal Artery Occlusion

Retinal artery occlusion (RAO) is characterized by a sudden, marked decrease in vision or even loss of vision, extremely narrowed retinal arteries, and gray-white retinal edema. Depending on the degree and location of the occlusion, it may be classified as central retinal artery occlusion (CRAO), branch retinal artery occlusion (BRAO), cilioretinal artery occlusion, or precapillary arteriole occlusion. In Traditional Chinese Medicine (TCM), this condition falls within the category of “sudden blindness due to collateral vessel obstruction” (络阻暴盲).

TCM Pattern Identification and Medication Reference

|Common Symptoms

Clinical Description:

The external eye appears normal, but blindness occurs suddenly. The posterior pole shows widespread gray-white retinal edema and opacity, with a cherry-red spot in the macula. Other features may include emotional distress, fullness and distension in the chest and flanks, a red tongue, a thin yellow coating, and a wiry pulse.

Plain-Language Explanation:

  • The eyes look normal from the outside.
  • Vision disappears suddenly, and the person cannot see.
  • A large area of the retina at the back of the eye is swollen, pale, and cloudy.
  • A small, bright-red spot appears in the central area of the retina.
  • The person feels emotionally low or distressed.
  • The chest and areas beside the ribs feel full, tight, or uncomfortable.
  • The tongue is somewhat red.
  • The tongue coating is thin and somewhat yellow.
  • The pulse feels tense, like a taut string, when palpated.

|Treatment Approach

Clinical Description:

Promote qi circulation and blood flow, open the orifices, and unblock the collaterals.

Plain-Language Explanation:

  • Encourage the smooth flow of stagnant qi to ease fullness, tightness, and discomfort from belching.
  • Promote blood flow and address stasis, with the aim of easing stabbing pain, numbness, and purplish discoloration.
  • Help open obstructed sensory pathways, with the aim of improving alertness and limb mobility and easing numbness, stiffness, and pulling pain.

|Related Medications

The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and package insert, and use under the guidance of a doctor or pharmacist.

|Common Symptoms

Clinical Description:

Vision drops suddenly, with moving spots or cloud-like haze in the field of view. The posterior pole shows widespread gray-white retinal edema and opacity. Other features may include headache, dizziness, irritability, a flushed face and red eyes, a red tongue with little coating, and a rapid, wiry pulse.

Plain-Language Explanation:

  • Vision suddenly worsens, making things much blurrier.
  • Moving dark spots or small shapes appear in the field of view, like flies or drifting clouds.
  • A large area of the retina at the back of the eye is swollen, pale, and cloudy.
  • Headache and dizziness may occur.
  • The person may become easily agitated or angry, with unsettled emotions.
  • The face and eyes look red.
  • The tongue is somewhat red, with a very thin coating or almost no coating.
  • The pulse feels tense and fast.

|Treatment Approach

Clinical Description:

Calm the liver and subdue rising yang; invigorate blood and unblock the collaterals.

Plain-Language Explanation:

  • Help calm rising liver yang, with the aim of easing dizziness, head pressure, irritability, and anger.
  • Promote blood flow and unblock the channels and collaterals, with the aim of easing numbness, pain, purplish discoloration, and stiffness.
  • Support limb movement and sensation so the limbs may feel more flexible and stronger.

|Related Medications

The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and package insert, and use under the guidance of a doctor or pharmacist.

Longdan Xiegan Wan

|Common Symptoms

Clinical Description:

After a prolonged course, vision remains dim and hazy. The arteries are narrow and pale red or appear as white lines; the retina is edematous, and the optic disc is pale. Other features may include shortness of breath, lack of strength, a sallow complexion, fatigue and reluctance to speak, aversion to cold and cold extremities, loose stools, a pale tongue with stasis spots, and a choppy or deep, thready pulse.

Plain-Language Explanation:

  • The condition has lasted a long time without clear improvement.
  • Things look dim and hazy and remain unclear.
  • The retinal arteries are narrowed and pale red, or look like fine white lines.
  • The retina at the back of the eye is swollen.
  • The optic disc at the back of the eye looks pale.
  • Breathing is short, and the person tires easily.
  • The complexion is yellowish and pale.
  • The person feels tired and low in energy and does not feel like talking.
  • The person feels cold easily, and the hands and feet are cold.
  • Stools are loose and poorly formed.
  • The tongue is pale, with dark purplish spots on its surface.
  • The pulse feels rough or uneven, or is deep and thready when pressed.

|Treatment Approach

Clinical Description:

Tonify qi and invigorate blood, resolve stasis, and unblock the vessels.

Plain-Language Explanation:

  • Support energy and stamina, with the aim of easing shortness of breath, weakness, and fatigue.
  • Promote smoother blood flow, with the aim of easing stabbing or distending pain and purplish discoloration of the limbs.
  • Address blood stasis and help it gradually disperse, with the aim of reducing firm areas and tenderness.
  • Unblock the vessels to support circulation and ease numbness, coldness in the hands and feet, and poor circulation.

|Related Medications

The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and package insert, and use under the guidance of a doctor or pharmacist.

References

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  2. Hu Guangwei, Hu Guangchun, Li Kejin. Observation of the therapeutic effect of Suxiao Jiuxin Pills in the treatment of retinal artery occlusion [J]. Journal of Integrated Chinese and Western Medicine Ophthalmology, 1995(2): 77–78.
  3. Meng Yuxia. Clinical analysis of Compound Xueshuantong Capsules in the treatment of fundus diseases [J]. China Medical Guide, 2015, 13(4): 229.
  4. Hu Luyun, Bao Zhijun, Liu Han, et al. Antithrombotic effects of Danhong Huayu Oral Liquid [J]. Chinese Journal of Experimental Traditional Medical Formulae, 2015, 21(10): 104–108.
  5. Liang Ronggen, Li Changhai. Report on the clinical ophthalmic application of Compound Danshen Dripping Pills [J]. Journal of Chinese Medicinal Materials, 1998, 21(10): 540.
  6. Li Qing, Zhang Minglian. Research progress on the treatment of retinal artery occlusion with traditional Chinese medicine [J]. Chinese Journal of Chinese Ophthalmology, 2013, 23(6): 457–460.
  7. Shi Yanyan, He Junping. Application of Longdan Xiegan Wan in ophthalmology [J]. Shaanxi Journal of Traditional Chinese Medicine, 2005, 26(11): 1239.
  8. Jin Ming. Clinical Rational Use of Chinese Patent Medicines for Common Conditions: Ophthalmology [M]. Beijing: Huaxia Publishing House, 2015: 120–158.