Pre and Post-arterial Recanalization Imaging of Central Retinal Artery Occlusions (CRAO)

Overview

Central retinal artery occlusions (CRAO) are the equivalent of an ischemic stroke at the retinal level. They share the same risk factors and common pathology. The diagnosis of a CRAO is clinically based on the sudden occurrence of a decrease in deep visual acuity with fundamentally signs of reactive ischemia. Small studies have highlighted the value of cerebral MRI (Magnetic Resonance Imaging) in CRAO with almost 25% of ischemic strokes found on diffusion sequences and the demonstration of a correlation between anomalies in diffusion sequence and the probability of a pathology with a high risk of recurrence (carotid stenosis or emboligenic cardiopathy). But there are usually few radiological signs that allow a direct positive diagnosis of CRAO, an etiologic diagnosis or a prognosis. This descriptive study will focus on CRAO at the diagnostic and post-treatment phases in the short and medium term, in order to (i) identify imaging etiologic signs of CRAO with specific sequences from a 3 Tesla MRI, (ii) identify positive diagnostic signs of CRAO with the same specific sequences, (iii) correlate these signs with the visual prognosis one month after the CRAO.

Study Type

  • Study Type: Observational
  • Study Design
    • Time Perspective: Prospective
  • Study Primary Completion Date: February 2024

Interventions

  • Device: Additional MRI sequences
    • Patients will be hospitalized for suspicion of CRAO. An “optimized” MRI will be performed with specific sequences: 3D T1 MSDE (Motion Sensitized Driven Equilibrium) “dark blood”; 3D Optimized diffusion centered on the optic nerves; 3D PD T1 after injection. A consultation of ophthalmology and a control MRI will be carried out one month after the CRAO. Again, specific sequences will be added: 3D T1 MSDE (Motion Sensitized Driven Equilibrium) “dark blood”; 3D Optimized diffusion centered on the optic nerves; DTI (Diffusion Tensor Imaging); 3D PD T1 after injection.

Clinical Trial Outcome Measures

Primary Measures

  • Contrast enhancement of the ophthalmic artery
    • Time Frame: Baseline
    • Binary variable (yes/no)
  • Presence of a thrombus
    • Time Frame: Baseline
    • Binary variable (yes/no)
  • Presence of an arterial stenosis of the supra aortic trunks
    • Time Frame: Baseline
    • Binary variable (yes/no)
  • Hypersignal of the ophthalmic artery in diffusion
    • Time Frame: Baseline
    • Binary variable (yes/no)
  • Restriction of the apparent diffusion coefficient (ADC) at the optic nerve level and at the papilla level
    • Time Frame: Baseline
    • Binary variable (yes/no)

Participating in This Clinical Trial

Inclusion Criteria

  • 18 years of age or older – CRAO (onset of symptoms ≤ 48 hours) – Consent to participate in the study Exclusion Criteria:

  • Contraindications to 3 Tesla MRI

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Fondation Ophtalmologique Adolphe de Rothschild
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Contact(s)
    • Laurence Salomon, MD PhD, 0148036431, lsalomon@for.paris

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