HomeHealth articlescentral retinal artery occlusionWhat Is a Cherry-Red Spot?

Cherry-Red Spot - Causes, Symptoms, Diagnosis, and Treatment

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The cherry-red spot is a fundoscopic examination feature of the eye's macula, found in cases of retinal infarction and retinal ischemia. Read to know more.

Written by

Dr. Sumithra. S

Medically reviewed by

Dr. Shikha Gupta

Published At September 12, 2022
Reviewed AtFebruary 8, 2023

Introduction

Cherry-red is a fundoscopic examination feature. The fundoscopic examination is done using a magnifying glass and a special light to study the fundus of the eyes. The fundus of the eye means the innermost part of the eye containing the retina and the optic nerve. Cherry-red spot occurs from the retinal edema due to various conditions like retinal artery occlusion and traumatic retinal ischemia, where the perimacular part of the retina will remain translucent and the fovea centralis (the blind spot) will be normal.

In simpler words, the fat accumulates in the retinal ganglion cells, surrounded by the fovea. The retinal ganglion cells will become cloudy and become white, while the fovea remains the same, giving a cherry-red spot look. This feature helps in diagnosing various underlying conditions associated with it. In most cases, the cherry-red spot will resolve on its own or diminish over time. But this does not mean that the condition is resolved either.

What Are the Causes of Cherry-Red Spot?

  • Central Retinal Artery Occlusion - The blood vessels supplying the retinal layer get blocked, causing vision loss. This can be caused due to increased blood sugar levels, blood pressure, and glaucoma.

  • Intraorbital Hemorrhage - It is caused due to an intraorbital trauma or surgery. This can compromise retinal circulation causing cherry-red spots.

  • Macular Infarction - It is a condition causing vision problems, but the cause is not known. A few suggest ocular trauma to be the cause in some cases.

  • Tay-Sachs Disease - It is a genetic disorder characterized by the absence of enzymes essential to break down the fatty content called gangliosides. The gangliosides start getting accumulated in the brain and ganglion cells of the retina, causing cherry-red spots.

  • Niemann-Pick Disease - It is a rare genetic disorder characterized by the body’s inability to metabolize the fats inside the cells.

  • Gangliosidosis - It is a name for a group of inherited diseases where the body lacks different proteins to break the fatty substances like gangliosides and resulting in its over-accumulation.

  • Sialidosis.

  • Farber’s Disease - It is characterized by the accumulation of lipids in the joints, tissues, and central nervous system. It is an inherited disorder.

  • Retinitis.

  • Retinal Necrosis - It is a necrotizing condition of the retinal layer caused by varicella zoster and herpes simplex virus.

  • Subacute Sclerosing Panencephalitis - It is a neurological condition characterized by brain inflammation related to measles infection.

  • Drug toxicity was also found to be a major cause. A few examples of the drugs are carbon monoxide, methanol, quinine, and dapsone.

  • Trauma induced retinal opacification, avulsion of the optic nerve and occlusion of the retinal artery are found to cause cherry-red spots.

What Are the Signs and Symptoms of Cherry-Red Spot?

  • Patients will experience sudden vision loss for a few seconds.

  • Older patients might experience headaches, difficulty chewing, joint aches, and weight loss.

  • Transient migraine will be present due to narrowing of the arteries.

How to Diagnose the Condition Associated with Cherry-Red Spot?

Diagnosing the underlying condition causing cherry-red spots is of utmost importance. A detailed history of the patient and a complete examination is required to narrow the condition causing it.

A complete history of the patient will be noted. The sudden vision loss will be assessed. The history of cardiovascular diseases present will be evaluated. Patients will be asked if a lysosomal storage disorder is present in any of the family members. Patients will be asked about drug usage, smoking and if they have had any eye injury.

The patient will be asked to undergo a series of diagnostic tests like carotid doppler ultrasonography, fundus autofluorescence, fluorescein angiography, computed tomography (CT), magnetic resonance imaging (MRI) . chest x-ray, echocardiography, electrocardiogram (ECG), magnetic resonance angiography (MRA), and blood pressure and pulse monitoring.

Lab tests are also considered to arrive at a diagnosis. Tests to find the complete blood count, blood sugar levels. Blood pressure, cholesterol levels, homocysteine levels, and erythrocyte sedimentation rate, C-reactive protein, lipid and triglycerides levels and molecular analysis of the cells or tissues.

What Are the Possible Differential Diagnoses of Cherry-Red Spot?

  • Macular hemorrhage.

How to Manage the Cherry-Red Spot and Associated Conditions?

In case of central retinal artery occlusion, doctors will recommend ocular massages; hyperbaric oxygen therapy, medications to decrease the intraocular pressure will be prescribed.

In cases of lysosomal storage disorders, doctors will recommend therapy to replace the enzymes, improve symptoms and reduce the intake of specific molecules.

Surgical removal of the clot will be suggested. Pars plana vitrectomy is the procedure done to remove the clot. It is a special procedure done by inserting specially designed tools through the sclera (the white part of the eye) and removing the vitreous humor and retina affected by the scar tissue.

What Is the Prognosis?

There is no clear evidence that suggests the above management to bring the lost vision back. But, the condition will improve and the symptoms can be controlled.

What Are the Complications Associated with It?

Neovascularization is the common complication of this condition. Neovascularization can be treated if there is not much delay in seeking a doctor.

Conclusion

Cherry-red spot is a fundoscopic feature and can be associated with various conditions. In this case, diagnosis plays a major part. A precise diagnosis is required to frame the treatment plan. There is no evidence that suggests vision loss can be treated. Only the conditions can be treated to some extent and the symptoms can be controlled. Seeking a doctor as soon as the first sign occurs will help the doctor manage the condition in a better way.

Frequently Asked Questions

1.

Why Do You Get a Cherry Red Spot?

 
The cherry red spot is a retinal edema condition caused by central retinal artery occlusion (CRAO), lysosomal storage disorders, and retinal ischemia. This can be diagnosed only through fundoscopic examination. Fundus is the part of the eye containing the retina and optic nerve.

2.

Is Cherry Red Spot Seen in Gaucher’s Disease?

Cherry red spots are typically seen in the center of the eye's macula. It is common with central retinal artery occlusion (CRAO), retinal ischemia, and lysosomal storage disorders. It is a common manifestation of Gaucher’s disease.

3.

When Should I Be Worried About a Red Spot?

The edema of the retina causes a cherry red spot. Various factors cause it. Usually, this cherry red spot resolves within four to six weeks provided the condition's cause is appropriately treated. Otherwise, it can cause neovascularization (formation of new blood vessels).

4.

What Is Tay-Sachs Disease Caused By?

Tay-Sachs disease is a genetic condition inherited from parents. It is characterized by the absence of an enzyme that breaks down fatty substances. These fatty substances will build up in the brain and spine affecting nerve function. This condition can be inherited only if both parents have the faulty gene.

5.

How Long Can a Person Live With Tay-Sachs?

Tays-Sachs is a genetic condition inherited from both parents that involve a gene not containing the enzyme essential for breaking down fats. Usually, a child affected by this condition will live for three to five years. Rarely this condition can start showing its effects in the later stages of life.

6.

Is Tay-Sachs More Common in Ethnicity?

Tays-Sachs is a very rare genetic condition. It is common among people of Ashkenazi Jewish heritage. This group of people belongs to Eastern Europe and Central Europe. This condition is fatal as it affects the functioning of the nerves due to fat buildup in areas of the brain and spine.

7.

Can Tay-Sachs Disease Be Detected Before Birth?

It is suggested to do a simple blood test before or during the phase of pregnancy to detect Tay-Sachs disease. The fetus in the womb can also be seen for the Tay-Sachs condition by a chorionic villus sampling test.

8.

What Is Retina Neovascularization?

The development of new blood vessels from the veins in the retinal layer of the eye characterizes retinal neovascularization. It can be caused due to conditions like diabetes, retinal or central vein occlusion, preterm birth, etc. Neovascularization can cause adverse eye conditions like retinopathy, macular degeneration, etc., and thus, requires immediate treatment. If treatment is delayed, treating the condition becomes difficult.
Dr. Shikha Gupta
Dr. Shikha Gupta

Ophthalmology (Eye Care)

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