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Abstract #8636 Published in IGR 5-1
Scanning laser polarimetry of the retinal nerve fiber layer in central retinal artery occlusion
Foroozan R; Buono LM; Savino PJ; Sergott RCOphthalmology 2003; 110: 715-718
PURPOSE: To report the results of scanning laser polarimetry (NFA/GDx; Laser Diagnostic Technologies, San Diego, CA). DESIGN: Prospective, consecutive observational case series. PARTICIPANTS: Ten consecutive patients with central retinal artery occlusion (CRAO). METHODS: Neuro-ophthalmic examination and scanning laser polarimetry of the retinal nerve fiber layer (RNFL) of ten patients with CRAO. MAIN OUTCOME MEASURES: Duration of visual loss, visual acuity, funduscopy, and scanning laser polarimetry of the RNFL in ten eyes of ten patients with CRAO. RESULTS: The duration of visual loss before examination and scanning laser polarimetry ranged from one to seven days. Visual acuity was counting fingers at one foot or worse in all ten eyes with CRAO, and funduscopy revealed pallid retinal edema accompanied by a cherry red spot in all affected eyes. Funduscopy of the fellow eyes in all but one patient, who had anterior ischemic optic neuropathy and was subsequently diagnosed with giant cell arteritis, revealed no acute changes. Scanning laser polarimetry of all eyes with CRAO revealed diffuse attenuation of the retardation of the RNFL. Scanning laser polarimetry of the fellow eye revealed a normal bimodal distribution in the eight patients in whom it could be measured. In one patient who was examined one day after the onset of visual loss, repeat nerve fiber analysis six weeks later revealed further depression of the RNFL compared with the initial scan. Repeat analysis of the RNFL in four other patients showed persistence of the diffuse depression noted during their initial examinations. CONCLUSIONS: Scanning laser polarimetry in CRAO reveals diffuse depression of the retardation of the RNFL, which occurs acutely after the onset of visual loss. To the authors' knowledge, these patients represent the first reports of scanning laser polarimetry of the RNFL in acute CRAO.
Dr. P.J. Savino, Wills Eye Hospital, Neuro-Ophthalmology Service, 900 Walnut Street, Philadelphia, PA 19107, USA
Classification:
2.13 Retina and retinal nerve fibre layer (Part of: 2 Anatomical structures in glaucoma)
6.9.1 Laser scanning (Part of: 6 Clinical examination methods > 6.9 Computerized image analysis)
10 Differential diagnosis e.g. anterior and posterior ischemic optic neuropathy
