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Introduction <p>To determine the incidence, clinical characteristics, and spatial associations of retinal arterial vasospasm in retinal vein occlusion (RVO), and to explore its relationship with aqueous humor endothelin-1 (ET-1) concentration.</p> Methods <p>This retrospective cohort study included 58 eyes with RVO that underwent wide-field fluorescein angiography (FA) within 1 month of presentation. In addition, aqueous humor samples were prospectively collected from a subset of 18 treatment-naïve RVO eyes. Arterial vasospasm was defined as a focal narrowing of the arterial lumen on early-phase FA. Cotton wool spots (CWS) and retinal hemorrhage were evaluated using color fundus photography and electronic medical records. Topographic concordance was assessed using quadrant-based, horizontal, and vertical hemifield classifications. Aqueous humor samples were analyzed for ET-1 concentration using enzyme-linked immunosorbent assay (ELISA).</p> Results <p>Arterial vasospasm was identified in 21 eyes (36.2%), including six eyes with central RVO and 15 eyes with branch RVO. Vasospasm was most commonly observed in the superotemporal quadrant and predominantly on second-order arteriolar branches (78.6%). CWS were more frequent in eyes with vasospasm compared with those without (81.0% vs. 54.1%; <i>p</i> = 0.050). Significant spatial concordance between vasospasm and CWS was observed in the vertical hemifield (<i>p</i> = 0.049), with no concordance observed with retinal hemorrhage location or severity. Exploratory aqueous humor analysis showed higher ET-1 concentrations in eyes with vasospasm (8.37 ± 4.59 vs. 5.74 ± 1.88&#xa0;pg/mL), although statistical interpretation was limited by the sample size.</p> Conclusion <p>Retinal arterial vasospasm is a relatively common but under-recognized feature of RVO. Its association with CWS and higher ET-1 levels suggests localized arterial endothelial dysfunction. Vasospasm may represent an arterial component of RVO pathophysiology and warrants further investigation.</p>

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Retinal Arterial Vasospasm in Retinal Vein Occlusion and Its Association with Aqueous Humor Endothelin-1

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月21日

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  • SolAh Han,
  • Chau Thi Ngoc Tran,
  • Jee Myung Yang,
  • Yoon Jeon Kim,
  • June-Gone Kim,
  • Young Hee Yoon,
  • Junyeop Lee

摘要

Introduction

To determine the incidence, clinical characteristics, and spatial associations of retinal arterial vasospasm in retinal vein occlusion (RVO), and to explore its relationship with aqueous humor endothelin-1 (ET-1) concentration.

Methods

This retrospective cohort study included 58 eyes with RVO that underwent wide-field fluorescein angiography (FA) within 1 month of presentation. In addition, aqueous humor samples were prospectively collected from a subset of 18 treatment-naïve RVO eyes. Arterial vasospasm was defined as a focal narrowing of the arterial lumen on early-phase FA. Cotton wool spots (CWS) and retinal hemorrhage were evaluated using color fundus photography and electronic medical records. Topographic concordance was assessed using quadrant-based, horizontal, and vertical hemifield classifications. Aqueous humor samples were analyzed for ET-1 concentration using enzyme-linked immunosorbent assay (ELISA).

Results

Arterial vasospasm was identified in 21 eyes (36.2%), including six eyes with central RVO and 15 eyes with branch RVO. Vasospasm was most commonly observed in the superotemporal quadrant and predominantly on second-order arteriolar branches (78.6%). CWS were more frequent in eyes with vasospasm compared with those without (81.0% vs. 54.1%; p = 0.050). Significant spatial concordance between vasospasm and CWS was observed in the vertical hemifield (p = 0.049), with no concordance observed with retinal hemorrhage location or severity. Exploratory aqueous humor analysis showed higher ET-1 concentrations in eyes with vasospasm (8.37 ± 4.59 vs. 5.74 ± 1.88 pg/mL), although statistical interpretation was limited by the sample size.

Conclusion

Retinal arterial vasospasm is a relatively common but under-recognized feature of RVO. Its association with CWS and higher ET-1 levels suggests localized arterial endothelial dysfunction. Vasospasm may represent an arterial component of RVO pathophysiology and warrants further investigation.