In vivo measurements of macular and nerve fibre layer thickness in retinal arterial occlusion

Abstract

Aim: To investigate the structure-function relationship in patients with retinal arterial occlusion by measuring the macular and the peripapillary retinal nerve fibre layer (RNFL) thickness and the visual sensitivity.

Methods: This is an observational case series with three patients with central retinal arterial occlusion (CRAO) and two patients with branch retinal arterial occlusion (BRAO). The macular/peripapillary RNFL thickness and the visual field were measured with Stratus optical coherence tomography (OCT) and Humphrey visual field analyzer, respectively, at least 1 year after the diagnosis of CRAO or BRAO.

Results: The macular thickness, in particular the inner retinal layer, and the peripapillary RNFL thickness were reduced in patients with retinal arterial occlusion. The decrease in the macular and the peripapillary RNFL thickness corresponded to the sites of retinal arterial occlusion with diffuse and segmental thinning found in CRAO and BRAO, respectively. Visual field defects were found in the corresponding locations of macular and RNFL thinning, and closely correlated with the degree of the structural damage.

Conclusions: Structural damages in terms of reduction in the macular and peripapillary RNFL thickness were evident in patients with retinal arterial occlusion. A close structure-function correlation was found and a worse functional outcome is associated with a more extensive thinning of the macula and RNFL. OCT measurements of the macular/peripapillary RNFL thickness provide useful indicators to reflect the severity of the disease in retinal arterial occlusion and serve as a new paradigm to study and monitor the disease longitudinally.