Which condition can cause a cherry red spot that must be differentiated from CRAO?

A cherry red spot is a clinical finding characterized by a pale optic disc surrounded by a bright red area in the retina, often indicating a condition that mimics central retinal artery occlusion (CRAO). Tay-Sachs disease is a genetic disorder that typically presents with neurological symptoms and can lead to cherry red spots in the macula due to the accumulation of GM2 gangliosides, especially in young children.

In Tay-Sachs disease, the cherry red spot arises as a result of the retinal pigment epithelium being untouched while the inner retinal layers are affected, making it distinctly different from CRAO, where the cherry red spot is seen because the fovea is the last area to be perfused due to its temporal location and increased blood flow.

Differentiating between these conditions is crucial as the management and underlying systemic implications vary significantly. While conditions such as central retinal vein occlusion, diabetic retinopathy, and age-related macular degeneration may cause other retinal changes, they are not typically associated with the classic cherry red spot appearance indicative of Tay-Sachs disease.