RT Journal Article SR Electronic T1 Time Course and Clinical Correlates of Retinal Diffusion Restrictions in Acute Central Retinal Artery Occlusion JF American Journal of Neuroradiology JO Am. J. Neuroradiol. FD American Society of Neuroradiology SP 1661 OP 1666 DO 10.3174/ajnr.A7201 VO 42 IS 9 A1 L.A. Danyel A1 M. Miszczuk A1 F. Connolly A1 K. Villringer A1 G. Bohner A1 M. Rossel-Zemkouo A1 E. Siebert YR 2021 UL http://www.ajnr.org/content/42/9/1661.abstract AB BACKGROUND AND PURPOSE: Retinal diffusion restrictions were recently identified as a regular finding in acute central retinal artery occlusion. We sought to investigate the influence of technical MR imaging and clinical parameters on the detection rate of retinal diffusion restrictions on standard brain DWI.MATERIALS AND METHODS: In this retrospective cohort study, MR imaging scans of patients with central retinal artery occlusion were assessed by 2 readers for retinal diffusion restrictions on DWI performed within 2 weeks after vision loss. The influence of clinical and technical MR imaging parameters and the time interval between symptom onset and DWI on the presence of retinal diffusion restrictions were evaluated.RESULTS: One hundred twenty-seven patients (mean age, 69.6 [SD 13.9] years; 59 women) and 131 DWI scans were included. Overall, the MR imaging sensitivity of retinal diffusion restrictions in acute central retinal artery occlusion was 62.6%–67.2%. Interrater and intrarater agreement for retinal diffusion restrictions was “substantial” with κinter = 0.70 (95% CI, 0.57–0.83) and κintra = 0.75 (95% CI, 0.63–0.88). Detection of retinal diffusion restrictions did not differ with differences in field strengths (1.5 versus 3T, P = .35) or sequence type (P = .22). Retinal diffusion restrictions were consistently identified within the first week with a peak sensitivity of 79% in DWI performed within 24 hours after symptom onset. Sensitivity of retinal diffusion restrictions declined in the second week (10.0%, P < .001). Absence of retinal diffusion restrictions was more prevalent in patients without fundoscopic retinal edema (60% versus 27.1%, P = .004) and with restitution of visual acuity at discharge (75% versus 28.4%, P = .006).CONCLUSIONS: Retinal diffusion restrictions in acute central retinal artery occlusion can be reliably identified on DWI performed within 24 hours and 1 week after onset of visual impairment. Detectability of retinal diffusion restrictions is dependent on the clinical course of the disease.CRAOcentral retinal artery occlusionlogMARLogarithm of the Minimum Angle of ResolutionRDRretinal diffusion restrictionsVAvisual acuity