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Stroke Risk Before and After Central Retinal Artery Occlusion in a US Cohort

      Abstract

      Objective

      To determine the risk of ischemic stroke, transient ischemic attack (TIA), and amaurosis fugax around the time of central retinal artery occlusion (CRAO).

      Patients and Methods

      Patients at Mayo Clinic sites with a diagnosis code of CRAO from January 1, 2001, through September 9, 2016, were reviewed. New CRAOs were confirmed, and ischemic stroke, TIA, and amaurosis fugax events were tallied within 15 days before and after CRAO.

      Results

      Three hundred patients with CRAO were included in the study cohort. The median age at the time of CRAO was 72 years (range, 19-100 years), and 158 (53%) were male patients. Overall, 16 patients (5.3%) had symptomatic ischemic stroke around the time of CRAO, with 7 strokes (2.3%) occurring 15 days before CRAO, 4 (1.3%) occurring simultaneously with CRAO, and 5 (1.7%) occurring after CRAO. Transient ischemic attack and amaurosis fugax were seen in 5 (1.7%) and 26 (8.7%) patients, respectively. It was found that 7% (9/128) of patients with embolic CRAO had a stroke around the time of CRAO as compared with 1.3% (2/149) of patients with an unknown cause of CRAO.

      Conclusion

      Symptomatic stroke, TIA, or amaurosis fugax is common around the time of CRAO. Therefore, CRAOs require urgent embolic work-ups.

      Abbreviations and Acronyms:

      CRAO (central retinal artery occlusion), CRVO (central retinal vein occlusion), MRI (magnetic resonance imaging), RAO (retinal artery occlusion), TIA (transient ischemic attack)
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      Linked Article

      • Retinal Occlusion, Ischemic Stroke, and the Brain-Eye Connection
        Mayo Clinic ProceedingsVol. 94Issue 2
        • Preview
          The risk of cerebral infarction associated with retinal ischemia has been the subject of an evolving debate. Several factors complicate this association, including varied types of ischemic visual events ranging from transient monocular visual loss to anterior ischemic optic neuropathy and retinal artery occlusion (branch or central); additionally, diagnostic and therapeutic options for cerebral ischemia continue to advance.
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