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Related Experiment Video

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Doppler Optical Coherence Tomography of Retinal Circulation
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Capturing the Occult Central Retinal Artery Occlusion Using Optical Coherence Tomography.

Shafi Balal1,2, Ahmed Said J'Bari3, Ali Hassan1,2

  • 1Ophthalmology Department, Moorfields Eye Hospital NHS Trust, London, UK.

Current Eye Research
|April 22, 2021
PubMed
Summary

Spectral-domain optical coherence tomography (OCT) can reveal inner retinal ischemia in central retinal artery occlusion (CRAO) cases missed on initial examination. Early OCT diagnosis aids in timely referral and prevents irreversible vision loss.

Keywords:
CRAOCentral retinal artery occlusionOCTRAOoptical coherence tomographyretinal artery occlusionspectral-domain optical coherence tomography

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Area of Science:

  • Ophthalmology
  • Neurology
  • Medical Imaging

Background:

  • Central retinal artery occlusion (CRAO) is an ophthalmic emergency with potentially irreversible vision loss.
  • Early-stage CRAO may present with unremarkable fundal examinations, leading to diagnostic delays.
  • Timely diagnosis is crucial for effective management and visual outcome preservation.

Observation:

  • This study retrospectively analyzed 11 cases initially misdiagnosed despite presenting with symptoms of CRAO.
  • Initial fundal examinations were unremarkable or suggested alternative diagnoses in these cases.
  • Spectral-domain optical coherence tomography (OCT) imaging from the initial presentation was reviewed.

Findings:

  • All 11 reviewed cases demonstrated evidence of inner retinal ischemia on initial OCT scans.
  • This inner retinal ischemia was indicative of impending or occult central retinal artery occlusion.
  • The findings highlight OCT's utility in detecting subtle signs of CRAO.

Implications:

  • OCT imaging can identify early signs of CRAO even when funduscopic examination is normal.
  • Improved early diagnosis of CRAO through OCT can facilitate prompt referral to stroke services.
  • This approach may help prevent irreversible vision loss associated with delayed CRAO treatment.