The retina can be affected in patients with ischemic vertigo caused by atherosclerotic lesions in the carotid and vertebral arteries, and researchers may have found a new way to detect this side effect. OCT imaging can provide an early and more objective differential diagnosis, a recent study suggests.
A team of investigators from Turkey evaluated differences in retinal nerve fiber layer (RNFL) thickness using OCT in 50 patients with ischemic vertigo and 50 age- and gender- matched healthy controls.
The researchers observed statistically significant differences in the superior, inferior and temporal quadrants between the groups:
Table 1. RNFL Thickness Measures | ||||
Right Eye | Left Eye | |||
Study Group | Control Group | Study Group | Control Group | |
Average | 96.70μm | 107.20μm | 95.80μm | 108.10μm |
Superior | 96.76μm | 122.34μm | 88.85μm | 126.22μm |
Inferior | 103.02μm | 132.10μm | 99.64μm | 124.03μm |
Nasal | 81.78μm | 85.64μm | 80.00μm | 82.34μm |
Temporal | 67.78μm | 85.82μm | 69.98μm | 81.03μm |
Diagnosis of ischemic vertigo is increasingly determined by neuroimaging methods, such as MRI, which don’t always show occlusion of the central retinal and labyrinth arteries with microemboli, the researchers noted. “When cranial arterial collateral circulation is considered for investigating the pathologies associated with the posterior system and ischemia in the anterior circulation, new techniques should be used. In our study, we aimed to use the vertebrobasilar Doppler method, which is the best indicator of posterior circulation ischemic vertigo, and OCT, which is used in anterior circulation disorders like central retinal artery, together,” the study authors concluded in their paper.
Currently, there is no effective method of neuroimaging in the diagnosis of central vertigo due to labyrinth ischemia.
Kocak MN, Ates O, Ondas O, et al. Differential diagnosis of ischemic vertigo by optical coherence tomography. Eurasian J Med. 2020;52(3):288-91. |