Retinal microvascular alterations in affected and contralateral eyes of individuals with unilateral central retinal artery occlusion.

OBJECTIVE

The aim of this study was to evaluate retinal microvascular characteristics in affected and contralateral healthy eyes of patients diagnosed with central retinal artery occlusion (CRAO), and to determine the presence of subclinical microvascular alterations in the contralateral eye.

METHODS

30 patients with unilateral CRAO were enrolled, with affected eyes designated as Group A and contralateral healthy eyes as Group B. An age-matched control group of 30 healthy individuals was included as Group C. All participants underwent assessment of best-corrected visual acuity (BCVA), intraocular pressure measurement, optical coherence tomography (OCT), optical coherence tomography angiography (OCTA), and neck ultrasonography. Retinal microvascular parameters, including central retinal thickness (CRT), foveal avascular zone (FAZ), and vascular density (VD), were measured and statistically analyzed to identify subclinical alterations in contralateral eyes.

RESULTS

Central retinal thickness (CRT) was higher in Group A (327.77±35.85 μm) than in Group C (251.17±7.02 μm, p < 0.05) and lower in Group B (240.30±5.19 μm) than in Group C (p < 0.05). The foveal avascular zone (FAZ) area differed significantly across all groups (A: 0.40±0.017 mm², B: 0.34±0.014 mm², C: 0.31±0.005 mm², p < 0.05). Superficial capillary plexus vascular density (SCP-VD) was reduced in Group A (40.21 %±2.97 %) compared with Group B (45.78 %±3.16 %) and Group C (46.97 %±2.60 %, p < 0.05), with no significant difference between Groups B and C. Deep Capillary Plexus (DCP-VD) and Radial Peripapillary Capillary (RPC-VD) densities differed significantly among all groups (p < 0.05). CRT in Group B demonstrated a correlation with SCP-VD (p = 0.016).

CONCLUSION

Subclinical microvascular alterations may be present in the contralateral healthy eyes of patients with CRAO, indicating a potential association between CRAO and systemic vascular changes. These findings underscore the importance of early evaluation of both eyes. OCTA serves as a valuable tool for visualizing retinal vascular structures, and supports early detection and management of retinal vascular abnormalities associated with CRAO.