Prevalence and Distribution of Macular Fluid with Central Retinal Artery Occlusion and Anterior Ischemic Optic Neuropathy

Abstract

Purpose

To examine the prevalence and distribution of fluid within a cohort of eyes with acute central retinal artery occlusion (CRAO) and non-arteritic anterior ischemic optic neuropathy (AION) using optical coherence tomography (OCT).

Methods

A retrospective analysis of patient records and OCT imaging. Patients presenting with acute CRAO or AION who had available macular OCT imaging and no co-morbidities known to cause macular fluid were included in the analysis. Baseline characteristics, visual acuity (VA), and fluid presence and distribution among the retinal layers were recorded.

Results

In the 16 eyes with acute CRAO, fluid was noted in 5 eyes (31%), which was mainly subretinal (3 eyes) or intraretinal located within the outer retinal layers (3 eyes). Only one eye had inner retinal cysts. Of the 11 eyes with acute AION, fluid was present in 8 eyes (73%). Subretinal fluid was noted in 4 eyes and extended to the foveal area in 3 of them, and outer retinal versus inner retinal cysts were noted in 6 versus 3 eyes, respectively. None of the eyes showed hard exudate deposition. In the small subset of eyes with CRAO and macular fluid that were followed-up, VA improved, while in eyes with AION, VA remained stable.

Conclusion

Macular fluid on OCT is not an uncommon feature of acute CRAO and AION and is mainly distributed within the outer retinal layers or subretinal space. Fluid is an understudied feature of retinal and optic nerve head infarction and may have a role in predicting neuronal damage extent and visual outcome.

Keywords:

• anterior ischemic optic neuropathy
• intraretinal fluid
• optical coherence tomography
• retinal artery occlusion
• subretinal fluid

Abbreviations

AION, anterior ischemic optic neuropathy; CRAO, central retinal artery occlusion; GCL, ganglion cell layer; INL, inner nuclear layer; IPL, inner plexiform layer; IRF, intraretinal fluid; LogMAR, logarithm of the minimal angle of resolution; NFL, nerve fiber layer; OCT, optical coherence tomography; ONH, optic nerve head; ONL, outer nuclear layer; OPL, outer plexiform layer; SD, standard deviation; SRF, subretinal fluid; VA, visual acuity.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

There is no funding to report.