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Central retinal artery occlusion without cherry-red spots.

Wei Fan1, Yanming Huang1, Yuancheng Zhao1

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Central retinal artery occlusion (CRAO) diagnosis can be challenging without cherry-red spots. Optical coherence tomography (OCT) showing inner retinal hyperreflectivity is key for early detection in these cases.

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Area of Science:

  • Ophthalmology
  • Medical Imaging
  • Retinal Vascular Diseases

Background:

  • Cherry-red spots are a critical diagnostic sign for central retinal artery occlusion (CRAO).
  • However, CRAO can present without the characteristic cherry-red spot.
  • Understanding the causes and diagnostic methods for CRAO without cherry-red spots is crucial.

Purpose of the Study:

  • To retrospectively analyze the clinical manifestations of CRAO.
  • To identify the causes and characteristics of CRAO cases that lack cherry-red spots.
  • To explore effective diagnostic methods for CRAO without cherry-red spots.

Main Methods:

  • Retrospective examination of 70 patients (70 eyes) with CRAO.
  • Collection of corrected distance visual acuity, fundus photos, fluorescein angiography (FA), and optical coherence tomography (OCT) images.
  • Analysis of causes for absent cherry-red spots and comparison of retinal findings between groups with and without cherry-red spots.

Main Results:

  • Posterior retinal whitening observed in 81.43% of CRAO cases; cherry-red spots present in 55.71%.
  • Reasons for absent cherry-red spots included leopard fundus, retinal vein occlusion, and lack of inner retinal necrosis.
  • OCT revealed inner retinal hyperreflectivity in 95.71% of CRAO patients; this finding was absent in the few cases without cherry-red spots.

Conclusions:

  • Multiple factors can contribute to the absence of cherry-red spots in CRAO.
  • Optical coherence tomography (OCT) detecting inner retinal hyperreflectivity is the most effective method for early diagnosis of CRAO without cherry-red spots.