To evaluate retinal vascular layers in Retinal Artery Occlusion (RAO) imaged by Optical Coherence Tomographic Angiography (OCTA).

A series of 4 eyes with acute RAO were enrolled in an observational case series study. Acute RAO was defined as symptoms lasting for less than 48 hours since the sudden visual loss, retinal whitening, and on OCT B-scan, inner retinal thickening, with disruption of the retinal layers. OCTA cube scans (3×3 mm) were acquired using the RTVue-XR Avanti AngioVue, with Split-Spectrum Amplitude-Decorrelation Angiography algorithm, and motion correction technology. Images of the superficial and deep capillary plexus were analyzed and compared with structural Optical Coherence Tomography (OCT).

OCTA findings were as decreased vascular perfusion in both the superficial and deep capillary plexuses corresponding to the areas of the inner retinal changes on OCT B-scan and fundus changes. Only large vessels were imaged. No vascular flow was observed in area nourished by the microvascular bed.

OCTA is a useful diagnostic tool used to demonstrate the features necessary to diagnose RAO. Compared to FA, OCTA is fast, noninvasive, and can provide improved visualization of microvascular details.