What clinical finding on fundoscopy indicates central retinal vein occlusion?

The "blood and thunder appearance" is a classic finding on fundoscopy that indicates central retinal vein occlusion (CRVO). This appearance is characterized by extensive retinal hemorrhages, cotton wool spots, and engorged retinal veins, creating a striking visual pattern that resembles a stormy sky. The presence of these characteristics arises from the occlusion of the central retinal vein, leading to the accumulation of blood and fluid within the retina.

CRVO results in compromised venous outflow, leading to significant retinal congestion and hemorrhage. This distinct finding aids in the early diagnosis of CRVO and can prompt further evaluation and management to address potential complications, such as macular edema and visual impairment.

In contrast, the other options do not reflect the characteristic findings associated with CRVO. For instance, a pale retina might suggest other conditions affecting retinal perfusion or ischemia but is not specific to CRVO. A cherry-red spot typically indicates conditions like central retinal artery occlusion (CRAO) rather than vein occlusion. Optic disc pallor is generally associated with chronic optic nerve damage or conditions affecting the optic nerve itself, further distinguishing it from the acute findings in CRVO. Therefore, recognizing the "blood and thunder appearance" is crucial for correctly identifying