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Analysis of Retinal and Choroidal Circulation During Central Retinal Vein Occlusion Using Indocyanine Green Videoangiography
Michel Paques, MD, PhD;
Valérie Garmyn, MD;
Antoine Catier, MD;
Karim Naoun, MD;
Eric Vicaut, MD, PhD;
Alain Gaudric, MD
Arch Ophthalmol. 2001;119:1781-1787.
Objective To explore the hemodynamic changes and their correlation with clinical presentation during central retinal vein occlusion.
Materials and Methods Retrospective, 2-center study. The medical records of 27 patients with central retinal vein occlusion were reviewed. For each patient, the plasma transit in central retinal vessels and in peripapillary choroidal vessels was analyzed using indocyanine green videoangiography.
Results The incidence of alteration in retinal plasma transit, ie, pulsatile filling of arteries and/or veins and increased arteriovenous filling time, was inversely correlated to duration from the onset but not to funduscopic features. Among the 14 patients with less than 1 month's duration of symptoms, 3 developed chronic macular edema, and impairment of arterial flow preceded its onset. Among the 10 patients with opticociliary circulation, choroidal drainage routes were identified in 5 cases, with pulsatile filling in 3.
Conclusions Early in the course of central retinal vein occlusion, arterial and/or venous flow alterations are present, irrespective of visual acuity, vein dilation, or fundus hemorrhages. These alterations are less frequent in chronic than in recent-onset central retinal vein occlusion. The mechanisms of these alterations remain uncertain but may involve arterial constriction and/or intermittent venous compression. The relationship between these alterations in retinal flow and the secondary onset of macular edema or capillary nonperfusion deserves further investigation.
From the Department of Ophthalmology (Drs Paques, Garmyn, Naoun, and Gaudric), Hôpital Lariboisière, Assistance-Publique-Hôpitaux de Paris, Université Paris VII and the Laboratoire d'Etude de la Microcirculation (Dr Vicaut), Paris, France; and the Department of Ophthalmology, Hôpital Pontchaillou, Rennes, France (Dr Catier). The authors have no commercial, proprietary, or financial interest in the products or companies described in this article.
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