ASSOCIATION BETWEEN RETINAL HEMORRHAGIC PATTERNS AND PERFUSION STATUS IN EYES WITH ACUTE CENTRAL RETINAL VEIN OCCLUSION.
OBJECTIVE
To evaluate peripheral retinal hemorrhagic patterns in eyes with acute central retinal vein occlusion, and to explore their clinical relevance in differentiating for the retinal perfusion status, through a prospective, and cross-sectional study.


METHODS
Fifty eyes with acute central retinal vein occlusion were included. Retinal hemorrhagic patterns at the equator and retinal perfusion status were evaluated by ultra-wide field fundus photography and fluorescein angiography.


RESULTS
Retinal perfusion was categorized as nonischemic in 29 eyes, ischemic in 18 eyes, and undeterminable in 3 eyes. None of the examined eyes had flame-shaped retinal hemorrhages in the periphery. All hemorrhages were rounded-dot or blot and were variable in size. Particle analysis was performed to quantify hemorrhage size, and showed higher values in eyes having larger blot hemorrhages, and lower values in eyes having dot or smaller blot hemorrhages. Mean size of maximum peripheral dot or blot hemorrhage was larger in eyes classified as ischemic (10,763.0 ± 5,946.3 pixels) than as nonischemic (2,839.9 ± 1,153.6 pixels, P < 0.001). The authors calculated area under the curve to investigate the ability of continuous variables to discriminate retinal perfusion status, which was 0.963 (P < 0.001) for mean size of maximum peripheral blot hemorrhages.


CONCLUSIONS
The authors objectively evaluated retinal hemorrhagic patterns at the equator in eyes with acute central retinal vein occlusion using particle analysis. The resulting hemorrhage size measurement was considered to be often useful in determining retinal perfusion status. Because they can be noninvasively evaluated with readily available equipment, peripheral hemorrhagic patterns might be good clinical markers of retinal perfusion.
*Department of Ophthalmology and Visual Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan; and †Department of Ophthalmology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
Yuki
Y
Muraoka
Akihito
A
Uji
Akitaka
A
Tsujikawa
Tomoaki
T
Murakami
Sotaro
S
Ooto
Kiyoshi
K
Suzuma
Ayako
A
Takahashi
Yuto
Y
Iida
Yuko
Y
Miwa
Masayuki
M
Hata
Nagahisa
N
Yoshimura
D000208:Acute Disease; D000368:Aged; D019540:Area Under Curve; D003430:Cross-Sectional Studies; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007511:Ischemia / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012166:Retinal Hemorrhage / Q000473:pathology*; D012170:Retinal Vein Occlusion / Q000503:physiopathology*; D012171:Retinal Vessels / Q000503:physiopathology*; D014792:Visual Acuity / Q000502:physiology; D014794:Visual Fields / Q000502:physiology