Color Doppler imaging and central retinal artery occlusion

PURPOSE: To assess the role of CDI of retrobulbar vessels in pathogenic diagnosis of CRAO. METHODS: We have used a sonographer with 9 MHz linear probe. RESULTS: We present four patients with CRAO that have no emboli visible on ophthalmoscopy The first patient had no blood flow signal on CDI on a surface of 2 millimeters behind the optic disc. B-scan ultrasound evaluation found a small round, moderate reflective echo within the optic nerve, 2 millimeters behind the optic disc. Carotid ultrasound examination found an ulcerated ateromatous plaque, as being the source of cholesterol emboli. The second patient had no detectable flow in central retinal artery due to multiple reverberations determined by calcic arterial emboli, placed 5 millimeters behind the optic disc. The chest X-ray showed an aortic plaque, considered the source of the emboli. The third patient had characteristic CDI findings for Horton disease: low blood velocities and high resistance index in all retrobulbar vessels, in both orbits. The diagnosis was sustained by carotid ultrasound. The last patient had a very low blood flow velocity in CRA, due to acute carotid occlusion. CONCLUSIONS: Ultrasound investigation is a valuable diagnostic tool for identifying potential systemic conditions associated with CRAO.