Purpose: To evaluate the role of optical coherence tomography (OCT)-based angiography (OCTA) in the diagnosis and monitoring of pediatric patients with retinal artery occlusion (RAO). Material and Methods: This retrospective study was conducted at the Department of Ophthalmology, The Children's Memorial Health Institute, in Warsaw between March 2015 and May 2016. Every patient underwent a complete ophthalmological examination. The diagnosis of the disease was based on fundus examination and fluorescein angiography (FA). OCT and OCTA were performed at baseline and every follow-up visit. Results: Four patients (4 eyes) (2 boys/2 girls, age 8-16 years) with RAO were enrolled in the study. In all cases, initial OCTA images revealed typical ischemic changes in superficial and deep retinal capillary plexuses. Follow-up OCTA revealed increasing areas of ischemia in the RAO region and persistent narrowing of the arteries. The loss of capillary network and the darker, smooth background due to ischemia were visible on OCTA images. Conclusions: OCTA enables clear visualization of progressive impairment of the retinal vascular perfusion in children with RAO and may be an alternative to the standard FA. Further studies are needed to confirm our results and establish the role of OCTA in pediatric patients.

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