FUNDUS CHANGES IN BRANCH RETINAL ARTERIOLAR OCCLUSION.
OBJECTIVE
To investigate systematically various fundus changes in branch retinal arteriolar occlusion (BRAO) and their natural history.


METHODS
The study comprised a cohort of 123 consecutive patients (135 eyes) with BRAO. Ophthalmic evaluation at initial and follow-up visits included recording visual acuity, visual fields, and detailed anterior segment and fundus examinations, and at initial visit fluorescein fundus angiography.


RESULTS
Probability estimates of retinal infarct still present were 89% 1 week after BRAO onset, 69% after 2 weeks, 67% after 3 weeks, 34% after 1 month, and 13% after 3 months. Optic disk pallor in the involved region developed in 21% within 1 month from onset, in 42% by 2 months, and in 65% by 3 months. Retinal arteriolar attenuation developed in 19% within 1 month from onset, and in 28% by 6 months. Arteriolar sheathing developed in 19% within 1 month and 25% within 12 months. Arteriolar emboli were found in 58%; 65% of those were at initial visit, in BRAO seen within 1 week of onset.


CONCLUSIONS
Most common cause of BRAO is embolism from the heart or carotid arteries; emboli usually get impacted at the arteriolar bifurcation. Migration and disappearance of retinal emboli is a common finding. Evolution of the retinal and optic disk changes is described.
*Department of Ophthalmology and Visual Sciences, College of Medicine, University of Iowa, Iowa City, Iowa; and †Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, Iowa.
Sohan S
SS
Hayreh
M Bridget
MB
Zimmerman
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001160:Arterioles / Q000473:pathology; D004617:Embolism / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006801:Humans; D007238:Infarction / Q000175:diagnosis / Q000503:physiopathology; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012161:Retinal Artery / Q000473:pathology*; D015356:Retinal Artery Occlusion / Q000175:diagnosis* / Q000503:physiopathology; D014065:Tonometry, Ocular; D014792:Visual Acuity / Q000502:physiology; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology