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 GroupStudy GroupControl Group
 Average 96.70μm107.20μm  95.80μm108.10μm 
 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.