OPTICAL COHERENT TOMOGRAPHY IN DIAGNOSIS OF ACUTE DISORDERS OF VENOUS BLOOD CIRCULATION IN THE RETINA AND THEIR COMPLICATIONS
Authors: Maksymuk O.Ju. 
Published: January 2021

A comprehensive ophthalmological examination of patients with acute disorders of venous blood circulation in the retina was carried out using a new, modern, non-contact and highly accurate method of diagnosing ophthalmological diseases – optical coherent tomography. The features of optical coherent tomography in patients with different types of acute disorders of venous blood circulation in the retina are described.

Comprehensive examination of such patients using traditional ophthalmological methods, biomicroophthalmoscopy, retinal photography using a fundus camera, fluorescent angiography, optical coherent tomography provides early diagnosis of macular edema and ischemic retinal zones.

We examined 62 patients with retinal vein occlusion. Ischemic type of retinal vein occlusion was diagnosed in 30 patients and non-ischemic type in 32 patients.

The average age of patients with ischemic thrombosis was 63.5 years. The initial visual acuity of the affected eye patients was low: 0.01-0.05 (20 patients with ischemic thrombosis) and 0.05-0.1 (10 patients with ischemic thrombosis) depending on the lesion of the macular retina zone.

On fluorescent angiograms of patients with ischemic retinal central vein thrombosis, there was a considerable elongation of retinal circulation time, asymmetry in contrasting the branches of the retinal central vein. The main sign of ischemic thrombosis was extensive hypo- and non-fluorescence retinal regions. In the later phases, hyperfluorescence of the optic disc and the macular region were recorded.

In patients with ischemic type of acute disorders of venous circulation in the retina, a thickening of the retina is detected on the optical coherent tomography, mainly due to diffuse and cystic macular edema, as well as exudative detachment of the neuroepithelium. Retinal thinning areas on optical coherent tomography responded to areas of capillary neperfusion.

The average age of non-ischemic thrombosis patients was 59.2 years. Non-ischemic thrombosis patients showed relatively high visual acuity. Initial visual acuity of 0.3 and above was found in 23 patients with non-ischemic thrombosis; 0.1 - 0.3 - in 5 patients; less than 0.1 - in 4 patients. Macular edema was one of the main reasons for the significant loss of vision in such patients.

On fluorescent angiograms of non-ischemic thrombosis patients, an increase in the time of venous perfusion was recorded, the time of contrasting arteries was in line with normal indicators. In the arterial-venous phase, hyperfluorescence of retinal veins, extraction of large vessels, dilation of capillaries and veins were detected. A hyperfluorescence of the optic disc, the macular region of the retina, has been detected as a result of edema of optic disc and the macular region of the retina. There were no areas of long capillary neperfusion and no signs of retinal neovascularization in non-ischemic thrombosis patients.

We have not found extensive areas of retinal thinning in patients with non-ischemic type of acute disorders of venous circulation in retina on optical coherent tomography. A slight thickening of the macular region with no change in retinal architecture has been detected in 5 patients with non-dischemical type of thrombosis

This approach makes it possible to predict the course of the disease and to prescribe appropriate treatment to prevent the neovascularization of the retina and the possible development of secondary neovascular glaucoma.