Optical coherence tomography findings in acute central retinal artery occlusion and their association with visual outcomes.

OBJECTIVES: This study aimed to summarize the optical coherence tomography (OCT) findings in central retinal artery occlusion (CRAO) and investigate their association with visual outcomes. METHOD: In this retrospective study, 63 cases (63 eyes) of CRAO were included. Clinical data, including age, gender, time of symptom onset, visual acuity (VA) and OCT images were collected and analysed. The morphology and reflectivity of different retinal layers on OCT images were assessed, and retinal thickness was measured using the built-in software of OCT system. The optical intensity of the retina was quantified using ImageJ software. RESULTS: The OCT findings in the 63 CRAO eyes were characterized by hyperreflectivity in the inner retinal layers (62 eyes, 98.4%) and retinal thickening (61 eyes, 96.8%), along with prominent middle limiting membrane (p-MLM) (42 eyes, 66.7%), hyporeflectivity of para-foveal outer retina (41 eyes, 65.1%), indistinct inner retinal layers (29 eyes, 46.0%), and foveal deformation (26 eyes, 41.3%). The inner and full retinal thickness in CRAO eyes was moderately positively correlated with the logarithm of the minimum angle of resolution (logMAR) VA at initial presentation and the last follow-up. Additionally, the optical intensity of the outer nuclear layer (ONL) and ellipsoid zone (EZ)-RPE complex was moderately negatively correlated with logMAR VA at presentation and the last follow-up. The ratio of inner retinal optical intensity to EZ/RPE optical intensity was moderately positively correlated with logMAR VA. CONCLUSION: OCT may assist in assessing visual outcomes in patients with CRAO. Retinal thickening and inner retinal hyperreflectivity are key OCT findings in CRAO, and these changes could provide valuable prognostic information.