Topography of Patchy Retinal Whitening during Acute Perfused Retinal Vein Occlusion by Optical Coherence Tomography and Adaptive Optics Fundus Imaging

• Published in: European journal of ophthalmology Vol. 21; no. 5; pp. 653 - 656
• Main Authors: Sarda, Valerie, Nakashima, Kiyoko, Wolff, Benjamin, Sahel, Jose-Alain, Paques, Michel
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01-09-2011
• Subjects: Acute Disease; Adult; Female; Humans; Imaging, Three-Dimensional; Ischemia - diagnosis; Retinal Vein Occlusion - physiopathology; Retinal Vessels - pathology; Tomography, Optical Coherence; Visual Acuity - physiology; Central retinal vein occlusion; Optical coherence tomography; Adaptive optics fundus imaging; Patchy macular whitening; Macular ischemia
• ISSN: 1120-6721; 1724-6016
• DOI: 10.5301/EJO.2011.6374

Purpose
During perfused retinal vein occlusions, patchy retinal opacification due to acute neuronal swelling may be present. This may be difficult to document using conventional imaging techniques.
Methods
Three-dimensional topography of focal retinal opacification was documented in a patient with hemiretinal vein occlusion by combining en face adaptive optics (AO) imaging with high-resolution optical coherence tomography (OCT).
Results
Patchy retinal opacification in the macula was faintly visible by color fundus photography with no angiographic correlation. Adaptive optics and OCT imaging showed that these areas were located in the plexiform layers while the nerve fiber layer remained spared. During follow-up, visual acuity returned to 20/20 with normalization of fundus features and of AO imaging. At last examination, optical coherence tomography showed thinning of the inner nuclear layer in the area previously opacified.
Conclusions
Patchy retinal opacification that may be observed at the acute phase of perfused central retinal vein occlusion corresponds to ischemic opacification of intermediary neurons within the inner nuclear and inner plexiform layers.