Visual field defects and changes in central retinal artery occlusion.

Area of Science:

• Ophthalmology
• Neuro-ophthalmology
• Retinal Vascular Diseases

Background:

• Acute central retinal artery occlusion (CRAO) is a critical condition causing sudden vision loss.
• Visual field defects (VFDs) are a common consequence, but their specific characteristics and evolution in CRAO are not fully understood.

Purpose of the Study:

• To investigate the characteristics and temporal changes of VFDs in patients with acute CRAO.
• To identify associations between VFDs and clinical parameters, including visual acuity, optical coherence tomography (OCT) findings, and CRAO stages.

Main Methods:

• Retrospective observational case series of 119 patients with acute non-arteritic CRAO.
• Utilized Goldmann perimetry for visual field assessment and optical coherence tomography (OCT) for retinal morphology.
• Analyzed baseline features and temporal changes in VFDs, correlating them with clinical parameters and CRAO stages.

Main Results:

• All patients exhibited VFDs, with 'temporal island' being the most frequent pattern (59%).
• Severe VFDs correlated with severe CRAO stages, poor baseline visual acuity, delayed perfusion, and significant OCT changes.
• Visual field improvement occurred in 39% of cases, associated with milder CRAO stages, better baseline visual acuity, and less severe initial VFDs.

Conclusions:

• Characteristic VFD patterns and their improvement in CRAO are linked to the severity of retinal ischemia.
• The mechanisms of VFDs in CRAO likely involve the interplay between retinal arterial perfusion and the ischemic vulnerability of retinal areas.