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Charlotte Fischer, Marlena Schnieder, Sebastian Bemme, Jan Liman, Nicolas Feltgen; The retrobulbar spot sign as a prognostic factor for central retinal artery occlusion. Invest. Ophthalmol. Vis. Sci. 2019;60(9):2562.
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The appearance of a retrobulbar spot sign in sonography is the correlate of a calcified embolus and may help to identify the etiology of the central retinal artery occlusion. But it remains uncertain, if the retrobulbar spot sign (SpS) may be a prognostic marker regarding the vision acuity.
In our ongoing prospective study we examined so far 20 patients (f=9, m=11; median age 71.55 years) with a non vasculitic central retinal artery occlusion regarding the appearance of a retrobulbar SpS and a prominent middle limiting membrane (PMLM) sign in the optical coherence tomography. A follow up was done after 4 and 12 weeks regarding the occurrence of a secondary retinal ischemia in retinal angiography and the vision acuity.
In 15 of 20 examined eyes (75%) of the patients a retrobulbar SpS was present. All patients without SpS and only 46.2% (6/13) with a SpS showed a PMLM sign in the optical coherence tomography, All (5/5) patients without SpS and 6.7% (1/15) of the patients without SpS showed a recanalisation of the occlusion in angiography.The vision acuity of the patients did improve in 75 % (3/4) oft the patients without a SpS and in 37,5% (7/8) of the patients with a SpS.A secondary retinal ischemia with neovascularisation occurred in 13.3% oft the patients with a spot sign and in none without a spot sign.
The retrobulbar spot sign seems to be an unfavorable predictor in central retinal occlusion regarding visual acuity and developement of retinael neovascularisation.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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