Abstract
Purpose::
To evaluate the optical coherence tomography (OCT) findings in retinal arterial occlusive disease (RAO) and emphasize the value of OCT in establishing the diagnosis.
Methods::
All patients who developed a permanent central (CRAO) or branch (BRAO) retinal arterial occlusive event at a single institution and whose assessment included OCT were included. The OCT findings in the acute and late phases of the process where evaluated when possible.
Results::
Fourteen eyes of 14 patients were identified. Seven of these had BRAO while the other 7 had CRAO. In the acute phase, the OCT findings of the involved area included retinal thickening, increased reflectivity of the nerve fiber layer, and swelling with decreased reflectivity of the outer retinal layers with or without cystic changes. The majority of the fluid accumulated in photoreceptor outer segments and nuclear layers. In the late phase, diffuse retinal thinning of the involved area with loss of the inner retina and preservation of the outer retinal layers was observed. Despite inner retinal atrophy, the vitreoretinal interface maintained the characteristic hyperreflective appearance on false color coding similar to that of the NFL in unaffected areas.
Conclusions::
OCT findings in retinal arterial occlusive disease are characteristic. Diffuse retinal thickening with outer retinal edema characterize the acute phase. This evolves into inner retinal atrophy in the late phase of the process. These late OCT findings may help confirm the diagnosis of RAO in cases of unexplained vision loss and may spare the need for electroretinography in the case of suspected CRAO.
Keywords: imaging/image analysis: clinical • vascular occlusion/vascular occlusive disease • retina