Cargando…

The Retrobulbar Spot Sign and Prominent Middle Limiting Membrane as Prognostic Markers in Non-Arteritic Retinal Artery Occlusion

Central retinal artery occlusion (CRAO) is characterized by the sudden, painless loss of vision. Typical sonographic and optic coherence tomography (OCT) findings are a retrobulbar spot sign and prominent middle limiting membrane (p-MLM) sign. It remains uncertain whether the retrobulbar spot sign a...

Descripción completa

Detalles Bibliográficos
Autores principales: Schnieder, Marlena, Fischer-Wedi, Charlotte V., Bemme, Sebastian, Kortleben, Mai-Linh, Feltgen, Nicolas, Liman, Jan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7831102/
https://www.ncbi.nlm.nih.gov/pubmed/33477523
http://dx.doi.org/10.3390/jcm10020338
_version_ 1783641566033739776
author Schnieder, Marlena
Fischer-Wedi, Charlotte V.
Bemme, Sebastian
Kortleben, Mai-Linh
Feltgen, Nicolas
Liman, Jan
author_facet Schnieder, Marlena
Fischer-Wedi, Charlotte V.
Bemme, Sebastian
Kortleben, Mai-Linh
Feltgen, Nicolas
Liman, Jan
author_sort Schnieder, Marlena
collection PubMed
description Central retinal artery occlusion (CRAO) is characterized by the sudden, painless loss of vision. Typical sonographic and optic coherence tomography (OCT) findings are a retrobulbar spot sign and prominent middle limiting membrane (p-MLM) sign. It remains uncertain whether the retrobulbar spot sign alone or coinciding with the appearance of p-MLM sign is a prognostic marker for visual acuity and the development of secondary retinal ischemia after CRAO. In our prospective cohort study, we included patients with a non-arteritic central artery occlusion < 4 weeks. We examined the following parameters at prespecified time points: ultrasound examination of orbital cavity, Spectral Domain-OCT examination, visual acuity test, and fundoscopy and ultra-widefield angiography to diagnose retinal vascularization. The presence of p-MLM sign in SD-OCT after CRAO was accompanied by significantly better vision during the first four weeks (2.3 (IQR 0.75) vs. 2.6 (IQR 0.33); p = 0.006). Moreover, the spot sign seems to be a prognostic factor for developing secondary retinal ischemia (8 (100%) vs. 0 (0%); p = 0.036). A retrobulbar spot sign seems to be a negative prognostic factor and is associated with secondary retinal ischemia, whereas a p-MLM sign is a somewhat positive prognostic factor for visual acuity.
format Online
Article
Text
id pubmed-7831102
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-78311022021-01-26 The Retrobulbar Spot Sign and Prominent Middle Limiting Membrane as Prognostic Markers in Non-Arteritic Retinal Artery Occlusion Schnieder, Marlena Fischer-Wedi, Charlotte V. Bemme, Sebastian Kortleben, Mai-Linh Feltgen, Nicolas Liman, Jan J Clin Med Article Central retinal artery occlusion (CRAO) is characterized by the sudden, painless loss of vision. Typical sonographic and optic coherence tomography (OCT) findings are a retrobulbar spot sign and prominent middle limiting membrane (p-MLM) sign. It remains uncertain whether the retrobulbar spot sign alone or coinciding with the appearance of p-MLM sign is a prognostic marker for visual acuity and the development of secondary retinal ischemia after CRAO. In our prospective cohort study, we included patients with a non-arteritic central artery occlusion < 4 weeks. We examined the following parameters at prespecified time points: ultrasound examination of orbital cavity, Spectral Domain-OCT examination, visual acuity test, and fundoscopy and ultra-widefield angiography to diagnose retinal vascularization. The presence of p-MLM sign in SD-OCT after CRAO was accompanied by significantly better vision during the first four weeks (2.3 (IQR 0.75) vs. 2.6 (IQR 0.33); p = 0.006). Moreover, the spot sign seems to be a prognostic factor for developing secondary retinal ischemia (8 (100%) vs. 0 (0%); p = 0.036). A retrobulbar spot sign seems to be a negative prognostic factor and is associated with secondary retinal ischemia, whereas a p-MLM sign is a somewhat positive prognostic factor for visual acuity. MDPI 2021-01-18 /pmc/articles/PMC7831102/ /pubmed/33477523 http://dx.doi.org/10.3390/jcm10020338 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Schnieder, Marlena
Fischer-Wedi, Charlotte V.
Bemme, Sebastian
Kortleben, Mai-Linh
Feltgen, Nicolas
Liman, Jan
The Retrobulbar Spot Sign and Prominent Middle Limiting Membrane as Prognostic Markers in Non-Arteritic Retinal Artery Occlusion
title The Retrobulbar Spot Sign and Prominent Middle Limiting Membrane as Prognostic Markers in Non-Arteritic Retinal Artery Occlusion
title_full The Retrobulbar Spot Sign and Prominent Middle Limiting Membrane as Prognostic Markers in Non-Arteritic Retinal Artery Occlusion
title_fullStr The Retrobulbar Spot Sign and Prominent Middle Limiting Membrane as Prognostic Markers in Non-Arteritic Retinal Artery Occlusion
title_full_unstemmed The Retrobulbar Spot Sign and Prominent Middle Limiting Membrane as Prognostic Markers in Non-Arteritic Retinal Artery Occlusion
title_short The Retrobulbar Spot Sign and Prominent Middle Limiting Membrane as Prognostic Markers in Non-Arteritic Retinal Artery Occlusion
title_sort retrobulbar spot sign and prominent middle limiting membrane as prognostic markers in non-arteritic retinal artery occlusion
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7831102/
https://www.ncbi.nlm.nih.gov/pubmed/33477523
http://dx.doi.org/10.3390/jcm10020338
work_keys_str_mv AT schniedermarlena theretrobulbarspotsignandprominentmiddlelimitingmembraneasprognosticmarkersinnonarteriticretinalarteryocclusion
AT fischerwedicharlottev theretrobulbarspotsignandprominentmiddlelimitingmembraneasprognosticmarkersinnonarteriticretinalarteryocclusion
AT bemmesebastian theretrobulbarspotsignandprominentmiddlelimitingmembraneasprognosticmarkersinnonarteriticretinalarteryocclusion
AT kortlebenmailinh theretrobulbarspotsignandprominentmiddlelimitingmembraneasprognosticmarkersinnonarteriticretinalarteryocclusion
AT feltgennicolas theretrobulbarspotsignandprominentmiddlelimitingmembraneasprognosticmarkersinnonarteriticretinalarteryocclusion
AT limanjan theretrobulbarspotsignandprominentmiddlelimitingmembraneasprognosticmarkersinnonarteriticretinalarteryocclusion
AT schniedermarlena retrobulbarspotsignandprominentmiddlelimitingmembraneasprognosticmarkersinnonarteriticretinalarteryocclusion
AT fischerwedicharlottev retrobulbarspotsignandprominentmiddlelimitingmembraneasprognosticmarkersinnonarteriticretinalarteryocclusion
AT bemmesebastian retrobulbarspotsignandprominentmiddlelimitingmembraneasprognosticmarkersinnonarteriticretinalarteryocclusion
AT kortlebenmailinh retrobulbarspotsignandprominentmiddlelimitingmembraneasprognosticmarkersinnonarteriticretinalarteryocclusion
AT feltgennicolas retrobulbarspotsignandprominentmiddlelimitingmembraneasprognosticmarkersinnonarteriticretinalarteryocclusion
AT limanjan retrobulbarspotsignandprominentmiddlelimitingmembraneasprognosticmarkersinnonarteriticretinalarteryocclusion