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.