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Narae Ko, Aaron Y Lee, Qinqin Zhang, Kasra Attaran-Rezaei, Raghu C Mudumbai, Cecilia S Lee, Ruikang K Wang; Evaluation of Retinal Artery Occlusions with Ocular Coherence Tomography Based Microangiography. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5478.
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© ARVO (1962-2015); The Authors (2016-present)
Central retinal artery occlusion (CRAO) is an important vascular cause of profound vision loss. Visualization of retinal vasculature using fluorescein angiography is limited. We report the results of ocular coherence tomography (OCT) based microangiography (OMAG) imaging of a patient who suffered sequential CRAO in both eyes.
Fundus photographs, spectral-domain OCT, and OMAG (67 kHz Cirrus HD-OCT prototype system, Carl Zeiss Meditec, Dublin, CA) images were obtained prior to the CRAO in the left eye and on multiple visits after the CRAO in both eyes. The retinal images were segmented into inner, middle, outer retinal layers using a semi-automated algorithm. The macula was divided in 9 zone Early Treatment Diabetic Retinopathy Study (ETDRS) grids. Perfusion index, defined as the percent coverage of the area by retinal vessels with flow, was calculated in each zone.
After the resolution of initial macular edema, the involved retina became atrophic during a period of 1-2 months following the CRAO in the right eye. OMAG images obtained on months 1 and 3 after the onset of CRAO in the right eye demonstrated visible absence of retinal vasculature except for the nasal macula, which was perfused by intact cilioretinal artery. The perfusion index in the nasal macula of the right eye was comparable to that of the left eye prior to CRAO. No significant change in perfusion index was observed in the right eye between months 1 and 3. Compared to the images prior to CRAO, OMAG images obtained on month 1 after CRAO in the left eye revealed diffuse loss of retinal capillary plexus and significant reduction in perfusion index in all 9 zones. Last recorded visual acuity 5 months after bilateral CRAOs were 20/25 eccentrically in the right eye and 20/400 in the left eye.
Extensive loss of retinal vasculature sparing the fovea was demonstrated using OMAG in CRAO of the right eye. Perfusion index after the onset showed minimal change over 3 months after the onset of CRAO. A significant reduction in perfusion index in all 9 ETDRS zones were noted in the left eye after the CRAO.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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