Retinal oedema in central retinal artery occlusion develops as a function of time

Area of Science:

• Ophthalmology
• Retinal Vascular Diseases
• Medical Imaging

Background:

• Non-arteritic central retinal artery occlusion (NA-CRAO) is a medical emergency where prompt diagnosis is crucial.
• The precise onset of vision loss in NA-CRAO is often difficult to ascertain, complicating timely treatment.
• Accurate estimation of ischaemia duration is vital for effective management and visual outcome prediction.

Purpose of the Study:

• To evaluate temporal changes in retinal thickness in acute NA-CRAO.
• To assess the potential of retinal thickness as a surrogate marker for estimating ischaemia onset.
• To investigate the correlation between retinal oedema progression and ischaemia duration.

Main Methods:

• Utilized optical coherence tomography (OCT) for continuous assessment of retinal thickness and oedema progression in porcine eyes.
• Conducted a retrospective analysis of 12 patients with acute NA-CRAO.
• Correlated OCT-measured retinal thickness with the duration of ischaemia within 9 hours of symptom onset.

Main Results:

• Observed a retinal oedema progression rate of 25.32 µm/hr in porcine models.
• Found a strong correlation between retinal oedema and ischaemia duration in NA-CRAO patients (Spearman's rho = 0.77, p = 0.004).
• Estimated a retinal thickness progression rate of 10.02 µm/hr in patients, indicating a potential biomarker for ischaemia onset.

Conclusions:

• Retinal thickness increase due to oedema formation is strongly correlated with ischaemia onset in both animal models and human NA-CRAO cases.
• Retinal thickness serves as a structural biomarker that may aid in estimating the timing of retinal ischaemia.
• Further prospective clinical trials are necessary to validate the clinical utility of retinal thickness measurements in managing NA-CRAO.