Abstract
Purpose :
To determine the time course of retinal vascular degeneration that appears to occur as a result of retrograde trans-synaptic degeneration. This study is based on our recent observation that attenuation of the retinal vasculature can occur several years after a retro-geniculate insult in a manner that matches retrograde trans-synaptic degeneration of the retinal ganglion cell layer.
Methods :
Patients with an ischemic stroke to the retro-geniculate visual pathway causing a homonymous visual field defect were recruited. Patients were classified based on the time between their stroke and testing (2 to 6 months; 6 months to 1 year; 1 year to 2 years, >2 years). Patients were excluded if they had a history of previous neurologic/ophthalmologic disease causing a visual field deficit. Each patient underwent optical coherence tomography (OCT) and OCT-Angiography (OCTA) of the peripapillary and macula regions, disc photos, and visual field (Humphrey 24-2) at a single time point.
Results :
Atrophy of the ganglion cell layer and superficial vascular plexus was noted in our patient population consistent with retrograde trans-synaptic degeneration. These deficits matched the pattern of visual field loss and showed a respect of the vertical midline. Vascular degeneration was noted within the first year of a retro-geniculate insult.
Conclusions :
In this study, using OCT-A, we show, in vivo, that retrograde trans-synaptic degeneration is associated with vascular degeneration. Further, we show that this vascular degeneration occurs within the first year following a retro-geniculate insult. This cross-sectional study helps better elucidate the time course of retinal changes post retro-geniculate stroke; however, prospective studies are needed to better characterize these changes.
This is a 2020 ARVO Annual Meeting abstract.