Longitudinal analysis of retinal changes after branch retinal artery occlusion using optical coherence tomography

Branch retinal artery occlusion (BRAO) causes inner retinal ischemia leading to permanent inner retinal dysfunction and visual field loss in affected retinal sectors. Optical coherence tomography (OCT) offers a novel way to evaluate in vivo retinal morphologic changes in BRAO in both acute and longitudinal phases. This case report describes OCT findings in BRAO at acute presentation and at follow-up, including the longitudinal evaluation of retinal and peripapillary retinal nerve fiber layer (RNFL) thickness.

A 58-year-old white man with an acute branch retinal artery occlusion was examined by OCT at initial presentation and at 2, 4, and 8 months. At initial presentation, OCT line scan showed thickening and hyper-reflectivity of the inner retina with shadowing of photoreceptor and retinal pigment epithelial layers. At 2 months, hyper-reflectivity and thickening were reduced. At 4 months, the inner retina showed no hyper-reflectivity and was attenuated. Peripapillary RNFL thickness was reduced in corresponding sectors. Findings at the 8-month follow-up were unchanged from the 4-month visit.

OCT provides useful information regarding the evolution of inner retinal attenuation in BRAO. Differential diagnosis of sectoral peripapillary RNFL thinning should include previous BRAO.