Purchase this article with an account.
Suk Ho Byeon, Young Kwang Chu, Young Taek Hong; In Vivo Detection of Acute Ischemic Retinal Damages; A ‘Prominent Middle Limiting Membrane’ Sign. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2658.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To describe characteristic findings of Acute ischemic retinopathy (AIR) in spectral domain optical coherence tomography (OCT)
This study included 18 acute retinal arterial occlusion (RAO) with more than 2 months follow up and 16 AIR cases from 15 central retinal vein occlusions (CRVO) and 1 case of acute retinal necrosis.RAO cases with available fundus photography (FP), OCT and/or fluorescence angiography (FA) in the early phase (< 1month) with more than 2 months follow up were reviewed. Sixteen cases showing clinical features of AIS from causes other than RAO, which later progressed to inner retina atrophy were also reviewed. A site to site analysis between OCT morphology and correlating FP images were done on each visit.
In RAO cases, the degree of retinal opacity was variable according to each case and area decreasing intensity as time passed. Increased reflectivity of the inner retina and a ‘prominent middle limiting membrane (MLM)’ in OCT were consistently noticed up to 1 month showing regional correlation with the retinal opaque areas. A prominent MLM, a hyper-reflectivity (cystoplasmic swelling) of the inner aspect of the outer plexiform layer (may involve bipolar cells synapses), was readily identified even in cases showing vague retinal opacities or coexisting masking conditions (CRVO). Acute ischemic damage which later progressed to inner retinal atrophy could be confirmed in the corresponding area with a previous prominent MLM.
A ‘Prominent MLM sign’ is an useful indicator of acute ischemic retinal damage, especially in cases showing subtle changes in retinal opacity and combined pathologies.
This PDF is available to Subscribers Only