Retinal thickness reflects relevant visual loss in patients with occipital lobe infarction

Xueling Bai ¹ Le Cao ¹ Hang Wang ¹ William Robert Kwapong ¹ Yuying Yan ¹ Guina Liu ² Junfeng Liu ¹ Fayun Hu ^1* Bo Wu ^1*

• ¹ Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
• ² Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China

We explored the relationship between retinal thicknesses and vessels using optical coherence tomography angiography (OCT)/ OCT angiography (OCTA) and clinical outcomes in occipital lobe infarction (OI). Methods: Fifty-two OI patients and 105 controls underwent macular OCT/OCTA scans covering a 6 × 6 mm 2 area around the fovea; the retinal nerve fiber layer (RNFL), ganglion cellinner plexiform layer (GCIPL), superficial vascular complex (SVC) and deep vascular complex (DVC) were measured by the OCT/OCTA tool. All participants underwent a visual acuity examination.Results: OI patients presented thinner GCIPL thickness, SVC density but higher DVC density (all p < 0.001) compared to the controls, both in the whole area and in four sectors. Eyes ipsilateral or contralateral to infarction showed thinner GCIPL thickness and SVC density (all p < 0.05). GCIPL thickness was significantly correlated with infarct diameter and visual acuity (both p < 0.05) while SVC density was also significantly correlated with infarct diameter (p = 0.002). Visual acuity showed a significant association with infarct diameter (p < 0.001) and the thinning of GCIPL partially mediates this effect (a proportion of mediated effect at 15.17%, p = 0.028). Conclusion: GCIPL thinning may account for the effect of infarct diameter in OI patients on visual acuity. Future prospective studies are needed to assess OCT/OCTA as a potential marker of visual loss in OI.