Find in Library

Abstract Purpose To report the clinical features, multi-modal imaging characteristics and their corroboration, and prognostic value of internal limiting membrane detachment (ILMD), a novel OCT biomarker in acute CRAO. Design Retrospective observational case-control study at institutional tertiary eye care centers. Methods 60 eyes of 60 patients of acute CRAO with optical coherence tomography (OCT) at baseline were included. Eyes were grouped in (a) With ILMD; (b) With no-ILMD. Multimodal imaging correlation, BCVA change and binary logistic regression were studied. Results Eighteen eyes (30%) were noted to have ILMD. At presentation, ILMD on OCT corroborated with macular non-perfusion with enlarged foveal avascular zone both on OCT-angiography (OCTA) and fundus fluorescein angiography (FFA). On follow-up, ILMD had resolved in all cases with fragmentation, disruption and atrophy of the retinal layers. Logistic regression showed poor baseline visual acuity was significantly associated with the odds of ILMD [Odds Ratio (OR) 31.02, p = 0.0018, 95% confidence interval: 1.81–529] while controlling for potential confounders including age (p = 0.60), gender (p = 0.316) duration of symptoms (p = 0.114), follow-up duration (p = 0.450) and final BCVA (p = 0.357). Eyes with ILMD and no-ILMD had a baseline BCVA of 2.62 LogMAR (light perception) and 2.05 LogMAR (Snellen equivalent 20/2000), respectively. On follow up, none of the eyes with ILMD showed any improvement. In contrast, nine (21.4%) eyes in no-ILMD had a vision of 20/400 and above with a mean final visual acuity of 1.87 + 0.78 LogMAR (p = 0.000). Conclusion ILMD correlated with macular non-perfusion and poor baseline visual acuity which showed no improvement on follow-up, suggesting it to be poor prognostic biomarker.