title: Retinal and choroidal changes and visual outcome in central retinal artery occlusion: an optical coherence tomography study.
abstract: OBJECTIVE
  To investigate the retinal and choroidal changes using spectral-domain optical coherence tomography (SD OCT) and to identify factors associated with visual outcome in eyes with central retinal artery occlusion (CRAO).
  
  
  METHODS
  Retrospective, observational case series.
  
  
  METHODS
  setting: Institutional.
  
  
  METHODS
  A total of 134 eyes diagnosed with acute (symptom onset ≤ 7 days) nonarteritic CRAO examined with SD OCT at baseline and follow-up visits.
  
  
  METHODS
  Based on funduscopic and angiographic findings, CRAO was categorized into 3 stages: incomplete, subtotal, and total. Abnormal morphologic features were evaluated from SD OCT images. Central macular thickness (CMT), inner and outer retinal thicknesses, and subfoveal choroidal thickness (SFCT) were measured. The clinical and SD OCT features were correlated with the final best-corrected visual acuities (BCVA).
  
  
  METHODS
  Retinal and choroidal thickness and BCVA.
  
  
  RESULTS
  Features of SD OCT at the initial presentation included inner and outer retinal thickening. At baseline, the frequency of inner and outer retinal thickening and macular edema (CMT > 300 μm) differed significantly among CRAO stages (all P < .05). SFCT in eyes with total CRAO was significantly thinner compared with that of the contralateral eyes (P = .009). A higher CRAO stage was associated significantly with macular edema at baseline (P < .001) and retinal thinning at the final visit (P = .010). Baseline CMT was correlated significantly with final BCVA (P < .001). Multivariate logistic regression analyses revealed that severe vision loss (BCVA < 20/200) was associated significantly with CRAO stage (P < .001) and baseline CMT (P = .005).
  
  
  CONCLUSIONS
  CRAO resulted in inner and outer retinal thickening in the acute stages and subsequent atrophic changes in the inner and outer retina. SD OCT may be a useful noninvasive imaging tool for diagnosis, staging, and prognosis of CRAO.
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Ophthalmology, Armed Forces Capital Hospital, Seongnam, South Korea.
authors.forename: Seong Joon
authors.initials: SJ
authors.lastname: Ahn
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea. Electronic address: sejoon1@snu.ac.kr.
authors.forename: Se Joon
authors.initials: SJ
authors.lastname: Woo
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
authors.forename: Kyu Hyung
authors.initials: KH
authors.lastname: Park
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
authors.forename: Cheolkyu
authors.initials: C
authors.lastname: Jung
authors.affiliation: Department of Neurology, Keimyung University Dongsan Medical Center, Daegu, South Korea; Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
authors.forename: Jeong-Ho
authors.initials: JH
authors.lastname: Hong
authors.affiliation: Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
authors.forename: Moon-Ku
authors.initials: MK
authors.lastname: Han
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002829:Choroid / Q000473:pathology*; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008269:Macular Edema / Q000145:classification / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012160:Retina / Q000473:pathology*; D015356:Retinal Artery Occlusion / Q000145:classification / Q000175:diagnosis* / Q000503:physiopathology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology*