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Spectral domain optical coherence tomography findings in eyes with acute ischaemic retinal whitening
  1. Patrick A Coady1,
  2. Emmett T Cunningham Jr1,2,3,
  3. Robin A Vora4,
  4. H Richard McDonald2,
  5. Robert N Johnson2,
  6. J Michael Jumper2,
  7. Arthur D Fu2,
  8. Sara J Haug2,
  9. Steven L Williams2,
  10. Brandon J Lujan2,5
  1. 1Department of Ophthalmology, California Pacific Medical Center, San Francisco, California, USA
  2. 2West Coast Retina Medical Group, San Francisco, California, USA
  3. 3Department of Ophthalmology, Stanford University School of Medicine, Stanford, California, USA
  4. 4Department of Ophthalmology, Kaiser Permanente Medical Center, Oakland, California, USA
  5. 5Department of Vision Science, University of California, Berkeley, California, USA
  1. Correspondence to Dr Brandon J Lujan, West Coast Retina Medical Group, 1445 Bush Street, San Francisco, CA 94109, USA; brandonlujanmd{at}gmail.com

Abstract

Acute retinal ischaemia presents in various forms depending on the type and location of the associated vascular occlusion. Cotton wool spots have been considered one manifestation of ischaemia and represent swelling in the nerve fibre layer. However, clinical retinal whitening also occurs in areas not affected by cotton wool spots, and has distinguishing spectral domain optical coherence tomography (SD-OCT) features. We present SD-OCT findings of hyper-reflectivity and thickening in four eyes with representative retinal arterial or retinal venous occlusions, specifically branch retinal artery occlusion, central retinal vein occlusion, Purtscher-like retinopathy and ophthalmic artery occlusion. The spectrum of retinal ischaemia from various causes was found to manifest in inner nuclear layer hyper-reflectivity and thickening on SD-OCT. En Face OCT imaging further characterises the topographical distribution of ischaemia, and reveals patterns which provide insight into the pathological processes involved.

  • Retina
  • Imaging

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