Abstract
Purpose :
To investigate the factors associated with visual field defect in eyes with central retinal artery occlusion (CRAO).
Methods :
A total of 119 eyes diagnosed with acute (symptom onset < 7 days) nonarteritic CRAO examined with goldmann perimetry and spectral-domain optical coherence tomography (SD OCT) at baseline and follow-up visits. Based on funduscopic and angiographic findings, CRAO was categorized into 3 stages : incomplete (33 eyes), subtotal (73 eyes), and total (13 eyes). Visual field defects (VFD) were analyzed and correlated with fluorescein angiography (FA) arm-to-retina time, initial and final best-corrected visual acuities (BCVA), and SD OCT features. VFD progression were categorized into 2 groups : better (28 eyes) and stationary/worse (44 eyes) compared to final and initial VFD and correlated with associated factors.
Results :
VFDs were classified as 5 types in the order of VFD severity : peripheral constriction without scotoma, paracentral scotoma, central and cecocentral scotoma, any types of island, and no target. At baseline, VFD types differed significantly among CRAO stages (p<0.001), initial BCVA (p=0.013), and baseline OCT morphologic features (p=0.036). FA arm-to-retina time differed significantly between no target and other VFD types (p<0.001), but no difference among other 4 VFD types (p=0.337). Baseline central macular thickness (CMT) differed significantly among no target, island, and other 3 VFD types (p<0.001), but no difference among other 3 VFD types (p=0.539). VFD types showed no difference between standard treatment group and intra-arterial thrombolysis group, according to CRAO stages. VFD progression identified significant difference among VFD types (p<0.001), CRAO stages (p<0.001), initial and final BCVA (p=0.009, p=0.003), baseline and final CMT (p=0.007, p=0.045), and baseline and final OCT morphologic features (p=0.023, p<0.001).
Conclusions :
Initial visual field defects and VFD progression in CRAO were associated significantly with CRAO stage, BCVA, and OCT features, but no difference in treatment modalities. Visual field defects may be another useful examination tool for diagnosis, staging and prognosis of CRAO.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.