Clinical Manifestations and Visual Prognosis of Cilioretinal Artery Sparing Central Retinal Artery Occlusion

다국어 초록 (Multilingual Abstract)

Purpose: To investigate the clinical manifestations and prognosis of eyes with cilioretinal artery sparing centralretinal artery occlusion (CRAO)Methods: A retrospective study was conducted on 90 eyes diagnosed with complete CRAO, including 16 casesof cilioretinal artery sparing CRAO. Clinical features, visual outcome, papillomacular bundle involvement, andremnant visual field were analyzed according to cilioretinal artery sparing.
Results: Among eyes with complete CRAO, the proportion of cilioretinal artery sparing CRAO was 17.8% (16/ 90). Mean initial best-corrected visual acuities (BCVAs) (2.04 ± 0.69 vs. 2.34 ± 0.47, p = 0.039) and finalBCVAs (1.65 ± 0.87 vs. 2.22 ± 0.84, p = 0.001) were significantly better in eyes of the cilioretinal artery sparinggroup than the non-sparing group. The proportion with poor visual outcome (final BCVA <20 / 200) was 81.3%in the cilioretinal artery sparing group and 97.3% in the non-sparing group (p = 0.01). In sub-group analysiswithin cilioretinal artery sparing CRAO eyes, ischemic involvement of the papillomacular bundle at disease onsetwas significantly more frequent in the poor vision group (BCVA <20 / 200, 12 / 13 [92.3%]) than in the goodvision group (BCVA ≥20 / 200, 1 / 3 [33.3%], p = 0.016) and it was associated with preserved central visualfield.
Conclusions: Although cilioretinal artery sparing is common in CRAO and has a better prognosis than completeCRAO, the visual outcome is generally poor and only a small proportion of eyes has preserved small centralvisual field. Ischemic injury of the papillomacular bundle at the acute stage of CRAO correlates with poor visualoutcome and could be a prognostic sign.

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