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B. Wolff, S. Tick, J. Girmens, J. Sahel, M. Paque; Topography of Retinal Ischemia During Central Retinal Vein Occlusion With Perivenular Whitening: a High Resolution Optical Coherence Tomography Study. Invest. Ophthalmol. Vis. Sci. 2009;50(13):3247.
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© ARVO (1962-2015); The Authors (2016-present)
Perivenular whitening (PVW) may be observed in a subset of patients with central retinal vein occlusion (CRVO). It is believed that PVW is related to acute retinal ischemia due to hypoperfusion. Here, we report the contribution of high resolution optical coherence tomography (OCT) to locate PVW within the retina.
The charts of four consecutive patients (aged 28 to 58 years; duration of symptoms 1 to10 days) with CRVO with PVW, seen at a single university-based ophthalmological center for which spectral domain OCT has been performed at the acute phase, were reviewed. The main outcome measure was the location of the PVW within retinal layers.
Areas of patchy opacification of the inner nuclear layer were observed, involving also the inner plexiform layer in one cases. The outer nuclear layer and the nerve fiber layer were unaffected. During follow-up, diffuse thinning and irregularity of the Outer plexifor layer (OPL) and Inner nuclear layer (INL) developed in all patients, extending beyond the area initially involved in PVW.
PVW is the fundoscopic manifestation of sectorial ischemic opacification primarily affecting the inner nuclear layer. The visual sequelea presented by these patients may be due to secondary atrophy of the INL
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