Original articleOptic disk and retinal nerve fiber layer damage after transient central retinal artery occlusion: an experimental study in rhesus monkeys☆
Section snippets
Material and methods
This study was conducted on 39 rhesus monkeys (Macaca mulatta), with a mean age of 19.5 ± 2.8 years (mean ± SD; median, 20 years; range, 13 to 24 years, equivalent to 50 to 90 years in humans). At Iowa City, experimental unilateral central retinal artery occlusion was produced in one eye of each monkey by performing a lateral orbitotomy and clamping the central retinal artery transiently, for a variable length of time, at its site of entry into the dural sheath of the optic nerve; the method is
Results
In this study, as in our previous studies with central retinal artery occlusion,3, 10, 11, 12 fluorescein fundus angiography showed that, despite complete occlusion of the central retinal artery by the clamp at its site of entry into the dural sheath of the optic nerve, the retinal vascular bed still filled very slowly and to a highly variable extent, by means of the various anastomoses established by the central retinal artery distal to the site of occlusion.13 The mechanism of filling of the
Discussion
In the present study, there was a significant correlation between duration of central retinal artery occlusion and decreased visibility of retinal nerve fiber layer (P = .018) and increased optic disk pallor (P = .014; Figure 5, Figure 6; there was also a trend between residual retinal circulation and decreased visibility of retinal nerve fiber layer (P = .085) and increased optic disk pallor (P = .162) Figure 7, Figure 8, Figure 9, Figure 10. It is possible that this was a trend but not a
Clinical implications
The primary objective of our experimental study was to find out how long the retina can survive with central retinal artery occlusion before it undergoes irreversible damage. It is essential to have that information before we can assess the outcome of treatment and the prognosis of central retinal artery occlusion in humans. It is also essential to know how applicable the findings of central retinal artery occlusion in elderly, atherosclerotic, hypertensive rhesus monkeys are to humans. The
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This work was supported by grant EY-1576 from the U.S. National Institutes of Health, in part by unrestricted grants from Research to Prevent Blindness, Inc, New York, New York, and by Deutsche Forschungsgemeinschaft (SFB 539). Dr. S. S. Hayreh is a Research to Prevent Blindness Senior Scientific Investigator.