Retinal Layer Reflectivity and Thickness as OCT Biomarkers for Diagnosis and Imaging-Based Stratification Relative to the 4.5-Hour Window in Acute Central Retinal Artery Occlusion - Summary - MDSpire

Retinal Layer Reflectivity and Thickness as OCT Biomarkers for Diagnosis and Imaging-Based Stratification Relative to the 4.5-Hour Window in Acute Central Retinal Artery Occlusion

  • By

  • Walter, Alessandra

  • Wenzel, Daniel A.

  • Poli, Sven

  • Druchkiv, Vasyl

  • Beuse, Ansgar

  • Schultheiss, Maximilian

  • Spitzer, Martin

  • Bartz-Schmidt, Karl Ulrich

  • Grohmann, Carsten

  • April 6, 2026

  • 0 min

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Objective:

To assess OCT-derived retinal layer reflectivity and thickness alterations in acute CRAO for expedited diagnosis and evaluation of ischemic tissue status within a 4.5-hour reperfusion window.

Key Findings:
  • The IRL/ORL reflectivity ratio effectively differentiated CRAO-affected eyes from fellow eyes (AUC = 0.98-0.99; p<0.001).
  • Retinal thickness increased in CRAO eyes across all ETDRS sectors except the foveal center, with AUC ranging from 0.78-0.99.
  • Both reflectivity and thickness metrics showed temporal dependence, with the IRL/ORL reflectivity ratio distinguishing <4.5 hours versus ≥4.5 hours (AUC 0.88-0.91).
Interpretation:

Quantitative OCT biomarkers based on reflectivity redistribution and retinal edema provide objective insights into ischemic tissue status, aiding in the diagnosis of acute CRAO.

Limitations:
  • Retrospective design may introduce bias.
  • Prospective validation needed, especially for unknown-onset CRAO cases.
Conclusion:

OCT-derived metrics may enhance acute stroke triage and telemedicine workflows, pending further validation.

Original Source(s)

Retinal Layer Reflectivity and Thickness as OCT Biomarkers for Diagnosis and Imaging-Based Stratification Relative to the 4.5-Hour Window in Acute Central Retinal Artery Occlusion

  • by Walter, Alessandra , Wenzel, Daniel A., Poli, Sven , Druchkiv, Vasyl , Beuse, Ansgar , Schultheiss, Maximilian , Spitzer, Martin , Bartz-Schmidt, Karl Ulrich, Grohmann, Carsten

  • April 6, 2026

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