A 65-year-old woman with diabetes, hypertension, and dyslipidemia presented to the ophthalmology clinic with a 14-hour history of painless, progressively worsening, blurry vision in the right eye. Physical examination was notable for a visual acuity of 20/400 in the right eye, with the patient unable to see fingers in the peripheral visual fields. There was a relative afferent pupillary defect in the right eye. What is the primary cause of this condition?
一名患有糖尿病、高血压和血脂异常的65岁女性在眼科门诊就诊，主诉右眼出现14小时的无痛性、逐渐加重的视物模糊。体格检查发现右眼视力为20/400，患者在周边视野中无法看到手指。右眼存在相对性传入性瞳孔缺陷。该疾病的主要原因是什么？
A. Acute ischemia of the optic nerve head视神经头急性缺血
B. Compression of a distal retinal vein by an overlying arteriole表层小动脉压迫远端视网膜静脉
C. Degeneration of photoreceptors and retinal pigment epithelium光感受器和视网膜色素上皮变性
D. Obstruction of venous outflow from a proximal retinal vein近端视网膜静脉回流受阻
E. Occlusion of a central retinal artery from an embolism栓塞导致的视网膜中央动脉闭塞
答案解析：
诊断为视网膜中央静脉阻塞。右眼眼底镜检查显示四个象限均存在视网膜出血和显著的静脉扩张——这些表现被称为“血暴”（blood and thunder）外观。同时还可见棉絮斑和视盘水肿。当急性血栓阻塞近端视网膜静脉的静脉回流时，就会发生视网膜中央静脉阻塞，导致突发性、无痛性视力丧失。目前已开始加强对心血管疾病危险因素的控制。
正确答案：E
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