Recent research suggests patients presenting with central retinal artery occlusion (CRAO) have a significantly higher risk of acute vascular ischemic events such as stroke and myocardial infarction immediately following the CRAO. A new retrospective cross-sectional study shows that risk has been increasing over the years, nearly doubling from 7.7% in 2003 to 15.3% in 2014.1
Researchers from Yale School of Medicine and West Virginia University School of Medicine reviewed the approximately 17,117 CRAO inpatient admissions in the United States from 2003 to 2014 to identify the risk of acute vascular ischemic events. They found 12.9% of CRAO patients admitted had a subsequent stroke in the hospital, while 3.7% had acute myocardial infarction. The combined risk of in-hospital stroke, transient ischemic attack, acute myocardial infarction or mortality was 19%. Further analysis revealed positive predictors of an in-hospital stroke included female gender, hypertension, carotid artery stenosis, aortic valve disease, smoking and alcohol dependence or abuse.1
“These findings emphasize that eye care providers should urgently refer patients with CRAO to stroke centers or emergency departments,” said Kathleen F. Freeman, OD, in a Practice Update commentary.2
1. Mir TA, Arham AZ, Fang W, et al. Acute vascular ischemic events in patients with central retinal artery occlusion in the United States: A nationwide study 2003-2014. Am J Ophthalmol. January 25, 2019. [Epub ahead of print].
2. Acute vascular ischemic events in patients with central retinal artery occlusion in the US. www.praticeupdate..com February 6, 2019.