Daniel A Wenzel1, Robert Kromer2, Sven Poli3,4, Nils Alexander Steinhorst2, Maria K Casagrande2, Martin S Spitzer2, Maximilian Schultheiss2. 1. University Eye Hospital, Centre of Ophthalmology, University Hospital Tübingen, Tübingen, Germany. 2. Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 3. Department of Neurology & Stroke, University Medical Center Tübingen, Tübingen, Germany. 4. Hertie Institute for Clinical Brain Research, University Hospital Tübingen, Tübingen, Germany.
Abstract
PURPOSE: Acute central retinal artery occlusion (CRAO) induces ischaemic retinal oedema. The purpose of this study was to define sensitivity and specificity of optical coherence tomography (OCT) based retinal thickness analysis in determining ischaemia onset in CRAO. METHODS: The relative retinal thickness increase (RRTI) in comparison with the fellow eye was analysed retrospectively in OCT scans of 66 patients diagnosed with CRAO between January 2010 and December 2019 within 48 hr of ischaemia onset. The natural course of RRTI and the sensitivity and specificity of OCT-based determination of ischaemia onset in identifying CRAO within 4.5 hr using the RRTI were evaluated. RESULTS: Relative retinal thickness increase (RRTI) in acute CRAO follows a hyperbolic curve with a steep incline within the early phase after which it reaches a plateau. Optical coherence tomography (OCT)-based retinal thickness analysis in CRAO allows to differentiate patients with ischaemia onset within the past 4.5 hr or thereafter with a sensitivity of 100% and a specificity of 94.3%. CONCLUSION: Relative retinal thickness increase (RRTI) allows to identify CRAO patients that are eligible for a potentially beneficial reperfusion therapy within a therapeutic window of 4.5 hr with a high accuracy. Especially in patients with unknown ischaemia onset, this diagnostic tool could be of major importance in the future clinical management.
PURPOSE: Acute central retinal artery occlusion (CRAO) induces ischaemic retinal oedema. The purpose of this study was to define sensitivity and specificity of optical coherence tomography (OCT) based retinal thickness analysis in determining ischaemia onset in CRAO. METHODS: The relative retinal thickness increase (RRTI) in comparison with the fellow eye was analysed retrospectively in OCT scans of 66 patients diagnosed with CRAO between January 2010 and December 2019 within 48 hr of ischaemia onset. The natural course of RRTI and the sensitivity and specificity of OCT-based determination of ischaemia onset in identifying CRAO within 4.5 hr using the RRTI were evaluated. RESULTS: Relative retinal thickness increase (RRTI) in acute CRAO follows a hyperbolic curve with a steep incline within the early phase after which it reaches a plateau. Optical coherence tomography (OCT)-based retinal thickness analysis in CRAO allows to differentiate patients with ischaemia onset within the past 4.5 hr or thereafter with a sensitivity of 100% and a specificity of 94.3%. CONCLUSION: Relative retinal thickness increase (RRTI) allows to identify CRAO patients that are eligible for a potentially beneficial reperfusion therapy within a therapeutic window of 4.5 hr with a high accuracy. Especially in patients with unknown ischaemia onset, this diagnostic tool could be of major importance in the future clinical management.
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