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Article

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

1
Department of Neurology, University Medical Center Göttingen, 37073 Göttingen, Germany
2
Department of Ophthalmology, University Medical Center Göttingen, 37073 Göttingen, Germany
*
Authors to whom correspondence should be addressed.
Marlena Schnieder and Charlotte V. Fischer-Wedi and Nicolas Feltgen and Jan Liman contributed equally to this work.
J. Clin. Med. 2021, 10(2), 338; https://doi.org/10.3390/jcm10020338
Received: 13 November 2020 / Revised: 11 December 2020 / Accepted: 14 January 2021 / Published: 18 January 2021
(This article belongs to the Section Ophthalmology)
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. View Full-Text
Keywords: sudden vision loss; imaging; optical coherence tomography; prognosis; visual acuity; central retinal artery occlusion sudden vision loss; imaging; optical coherence tomography; prognosis; visual acuity; central retinal artery occlusion
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MDPI and ACS Style

Schnieder, M.; Fischer-Wedi, C.V.; Bemme, S.; Kortleben, M.-L.; Feltgen, N.; Liman, J. The Retrobulbar Spot Sign and Prominent Middle Limiting Membrane as Prognostic Markers in Non-Arteritic Retinal Artery Occlusion. J. Clin. Med. 2021, 10, 338. https://doi.org/10.3390/jcm10020338

AMA Style

Schnieder M, Fischer-Wedi CV, Bemme S, Kortleben M-L, Feltgen N, Liman J. The Retrobulbar Spot Sign and Prominent Middle Limiting Membrane as Prognostic Markers in Non-Arteritic Retinal Artery Occlusion. Journal of Clinical Medicine. 2021; 10(2):338. https://doi.org/10.3390/jcm10020338

Chicago/Turabian Style

Schnieder, Marlena, Charlotte V. Fischer-Wedi, Sebastian Bemme, Mai-Linh Kortleben, Nicolas Feltgen, and Jan Liman. 2021. "The Retrobulbar Spot Sign and Prominent Middle Limiting Membrane as Prognostic Markers in Non-Arteritic Retinal Artery Occlusion" Journal of Clinical Medicine 10, no. 2: 338. https://doi.org/10.3390/jcm10020338

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