G Alex Ochakovski1,2, Daniel A Wenzel3, Martin S Spitzer1,3, Sven Poli4,5, Florian Härtig4,5, Manuel Dominik Fischer1,2,6,7, Spyridon Dimopoulos1, Maximilian Schultheiss3. 1. Centre for Ophthalmology, University Eye Hospital, University Hospital Tübingen, Tübingen, Germany. 2. Institute for Ophthalmic Research, Centre for Ophthalmology, University Hospital Tübingen, Tübingen, Germany. 3. Department of Ophthalmology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany. 4. Department of Neurology & Stroke, University Medical Center Tübingen, Tübingen, Germany. 5. Hertie Institute for Clinical Brain Research, University Hospital Tübingen, Tübingen, Germany. 6. STZ eyetrial at the Centre for Ophthalmology, University Hospital Tübingen, Tübingen, Germany. 7. Nuffield Laboratory of Ophthalmology, University of Oxford, Oxford, UK.
Abstract
PURPOSE: Time is the key criterion in the management of non-arteritic central retinal artery occlusion (NA-CRAO). However, the precise onset of vision loss is often difficult to determine. This study aimed to evaluate the temporal changes of retinal thickness in acute NA-CRAO and the potential of this parameter to be used as a surrogate marker to estimate the onset of retinal ischaemia. METHODS: Optical coherence tomography was used to continuously assess retinal thickness and oedema progression rate in six porcine eyes. Additionally, a retrospective analysis of 12 patients with acute NA-CRAO was performed to determine association strength and progression rate between retinal thickness and onset of ischaemia. All Optical coherence tomography (OCT) scans (pigs and NA-CRAO patients) were performed within an ischaemic time frame of up to 9 hr. RESULTS: Retinal oedema progression rate in pigs was 25.32 µm/hr [CI 95%: 24.24-26.40 µm/hr]. Retrospective analysis of the patients revealed a strong correlation between retinal oedema and duration of ischaemia (Spearman's rho = 0.77, p = 0.004) with an estimated progression rate of 10.02 µm/hr [CI 95%: 3.30-16.74 µm/hr]. CONCLUSION: Retinal thickness increases with oedema formation, and ischaemia onset is strongly correlated with this structural biomarker in both, pigs and NA-CRAO patients. Prospective clinical trials will have to determine the clinical feasibility of retinal thickness measurements as a biomarker to support clinical management of NA-CRAO.
PURPOSE: Time is the key criterion in the management of non-arteritic central retinal artery occlusion (NA-CRAO). However, the precise onset of vision loss is often difficult to determine. This study aimed to evaluate the temporal changes of retinal thickness in acute NA-CRAO and the potential of this parameter to be used as a surrogate marker to estimate the onset of retinal ischaemia. METHODS: Optical coherence tomography was used to continuously assess retinal thickness and oedema progression rate in six porcine eyes. Additionally, a retrospective analysis of 12 patients with acute NA-CRAO was performed to determine association strength and progression rate between retinal thickness and onset of ischaemia. All Optical coherence tomography (OCT) scans (pigs and NA-CRAO patients) were performed within an ischaemic time frame of up to 9 hr. RESULTS:Retinal oedema progression rate in pigs was 25.32 µm/hr [CI 95%: 24.24-26.40 µm/hr]. Retrospective analysis of the patients revealed a strong correlation between retinal oedema and duration of ischaemia (Spearman's rho = 0.77, p = 0.004) with an estimated progression rate of 10.02 µm/hr [CI 95%: 3.30-16.74 µm/hr]. CONCLUSION:Retinal thickness increases with oedema formation, and ischaemia onset is strongly correlated with this structural biomarker in both, pigs and NA-CRAO patients. Prospective clinical trials will have to determine the clinical feasibility of retinal thickness measurements as a biomarker to support clinical management of NA-CRAO.
Authors: Maria Casagrande; Robert Kromer; Daniel A Wenzel; Sven Poli; Martin S Spitzer; Vasyl Druchkiv; Maximilian Schultheiss; Spyridon Dimopoulos Journal: J Ophthalmol Date: 2021-04-14 Impact factor: 1.909
Authors: Daniel A Wenzel; Sven Poli; Maria Casagrande; Vasyl Druchkiv; Martin S Spitzer; Karl Ulrich Bartz-Schmidt; Carsten Grohmann; Maximilian Schultheiss Journal: Front Med (Lausanne) Date: 2022-07-06