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Related Experiment Video

Updated: May 2, 2026

Retinal Vascular Reactivity as Assessed by Optical Coherence Tomography Angiography
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A Remote Consult Retinal Artery Occlusion Diagnostic Protocol.

Gareth M C Lema1, Reade De Leacy2, Michael G Fara2

  • 1Icahn School of Medicine at Mount Sinai, New York, New York; New York Eye and Ear Infirmary of Mount Sinai, New York, New York; James J. Peters VA Medical Center, Bronx, New York.

Ophthalmology
|February 13, 2024
PubMed
Summary
This summary is machine-generated.

A new protocol using point-of-care OCT and remote consults successfully diagnosed retinal artery occlusions. This approach improved visual acuity in treated patients, demonstrating its utility for ophthalmic emergencies.

Keywords:
Central retinal artery occlusionEye strokeFibrinolysisOCTRemote consultTelehealthTissue plasminogen activator

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Area of Science:

  • Ophthalmology
  • Neurology
  • Medical Technology

Background:

  • Retinal artery occlusions (RAOs) are time-sensitive emergencies causing vision loss.
  • Rapid diagnosis and treatment are crucial for visual recovery.
  • Current diagnostic pathways may delay timely intervention.

Purpose of the Study:

  • To introduce and evaluate a novel protocol for diagnosing RAOs at the point of care.
  • To assess the efficacy of using Optical Coherence Tomography (OCT) combined with a remote consult model.
  • To determine the impact of this protocol on treatment times and patient outcomes.

Main Methods:

  • Retrospective case series evaluating a new diagnostic technology.
  • Implementation of OCT in stroke centers/emergency departments for patients with sudden monocular vision loss.
  • Remote interpretation of OCT images by a retina service.
  • Treatment with intra-arterial tissue plasminogen activator (IA-tPA) for eligible patients.
  • Assessment of visual acuity (VA) and treatment times.

Main Results:

  • 59 patients evaluated over 18 months; 25 (42%) confirmed RAOs.
  • 9 patients treated with IA-tPA showed significant VA improvement within 24 hours (logMAR 2.14 to 0.7, P=0.0001).
  • Mean time from presentation to treatment was 146 minutes, with mean time from last known well (LKW) to treatment of 543 minutes.

Conclusions:

  • Successful implementation of a remote consult protocol using point-of-care OCT for RAO diagnosis.
  • This novel approach facilitates timely diagnosis and treatment of ophthalmic emergencies.
  • Demonstrates the potential of remote consult services in managing time-critical conditions.