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Silja Bairov, Philipp Ackermann, Maike Brachert, David Finis, Philipp Albrecht, Gerd Geerling, Orhan Aktas, Rainer Guthoff; Extension of alteration of retinal neurosensory layers in central retinal artery occlusion. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3387.
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© ARVO (1962-2015); The Authors (2016-present)
The aim is to in vivo determine the impact of central retinal artery occlusion (CRAO) on the neurosensory retinal layers Most patients with CRAO present with painless profound visual loss. Histopathologically the acute ischaemia leads to a localized infarction of the inner two thirds of neurosensory retina supplied by the intrinsic retinal vessels. Spectral-domain optical coherence tomography (SD-OCT) allows to characterise these dynamic alterations of retinal ischaemia in vivo.
We analysed cross-sectionally 15 patients (10 female and 5 male, mean age 76,4±8,7 years) at day 1, 2, 4, 5, 6, 7, 10, 20, 23, 38 and 53 after onset of symptomatic CRAO. The examination included visual acuity, slit-lamp biomicroscopy, fundoscopy and fluorescein angiography. The total retinal thickness (TRT) was measured at the nasal edge of the fovea at the horizontal foveal scan on SD-OCT. The retinal nerve fibre layer (NFL), ganglion cell and inner plexiform layer complex (GCL/IPL), the inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL) and retinal pigment epithelium complex (RPE) were manually determined and measured by the application software. The healthy contralateral eyes served as controls.
Mean TRT was increased (474 ±137µm) compared to controls (347 ± 14). TRT and the inner retinal layers showed increased thickness values in the acute phase measured at day 1 to 20 (TRT), respectively 6 (RNFL, GCL/IPL), which decreased thereafter in contrast to the controls eyes. INL remained considerably thickened (68±23µm) compared to controls (36±8µm), while thickness of OPL (37±32), ONL (110±18µm) and RPE (67±19) were moderately raised compared to respective control layers (32±6µm, 99±11, 58±9).
SD-OCT provides an in-vivo view of dynamic retinal alteration following retinal artery obstruction and helps to understand the pathophysiology in retinal ischaemia.
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