Purpose: The aim of this study was to analyse the pulsatility of the central retinal artery on fluorescein angiography in patients with central retinal vein occlusion (CRVO), and to correlate it with visual function and the degree of retinal ischemia.
Methods: This was a retrospective study of patients with treatment naive CRVO who underwent ophthalmic examination, dynamic fluorescein angiography (FA) and optical coherence tomography (OCT). FA video films were analysed for the presence and the number of pulsations. Other parameters such as arterial filling time and arteriovenous time were also measured. FA images were graded for the degree of retinal haemorrhages and the degree of retinal and macular ischemia. Central retinal thickness (CRT) was measured on OCT scans. Optical coherence tomography angiography (OCT-A) values such as deep and superficial vascular densities, foveal avascular zone (FAZ) and flow density (FD) were also collected if available, for comparison with dynamic FA features.
Results: The study included 76 eyes of 76 patients (mean age: 67 years ± 20.5) including 46 men (61%). Presence of arterial pulsatility was identified in 51% of cases. The number of pulsations was significantly higher in patients with CRVO who had more severe retinal ischemia. (p = 0.045). No significant correlation was found between visual function and hemodynamic factors.
Higher age and a more severe degree of hemorrhages on FA were also significantly associated with increased retinal ischemia (p = 0.025 and p = < 0.0001, respectively). The severity of macular ischemia was negatively correlated with best-corrected visual acuity (p = 0.039).
Conclusion: Our study demonstrated an increased number of pulsations in CRVO eyes with greater degree of ischemia, possibly reflecting a an arterial component of the vasoobstruction. In contrast, a good visual acuity is possible even in the presence of slow arterial blood flow or severe pulsatility.