The Association of Central Retinal Artery Occlusion and Extracranial Carotid Artery Disease

Douglas, Daniel; Schuler, James J.; Buchbinder, Dale; Dillon, Bruce C.; Flanigan, D. Preston

doi:10.1097/00000658-198807000-00012

Cited by 52 publications

(22 citation statements)

References 12 publications

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“…CRAO and, to a lesser extent, BRAO are associated with a high degree of morbidity and mortality due to permanent, severe vision loss, as well as the immediate and long-term ocular and systemic risks associated with acute retinal ischemia (35,50–54). Fortunately, both CRAO and BRAO are often monocular disorders.…”

Section: Morbidity and Mortalitymentioning

confidence: 99%

Acute retinal arterial ischemia

Dattilo¹,

Newman²,

Biousse³

2018

Ann. Eye Sci

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Acute retinal arterial ischemia, which includes transient monocular vision loss (TMVL), branch retinal artery occlusion (BRAO), central retinal artery occlusion (CRAO) and ophthalmic artery occlusion (OAO), is most commonly the consequence of an embolic phenomenon from the ipsilateral carotid artery, heart or aortic arch, leading to partial or complete occlusion of the central retinal artery (CRA) or its branches. Acute retinal arterial ischemia is the ocular equivalent of acute cerebral ischemia and is an ophthalmic and medical emergency. Patients with acute retinal arterial ischemia are at a high risk of having further vascular events, such as subsequent strokes and myocardial infarctions (MIs). Therefore, prompt diagnosis and urgent referral to appropriate specialists and centers is necessary for further work-up (such as brain magnetic resonance imaging with diffusion weighted imaging, vascular imaging, and cardiac monitoring and imaging) and potential treatment of an urgent etiology (e.g., carotid dissection or critical carotid artery stenosis). Since there are no proven, effective treatments to improve visual outcome following permanent retinal arterial ischemia (central or branch retinal artery occlusion), treatment must focus on secondary prevention measures to decrease the likelihood of subsequent ischemic events.

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Section: Morbidity and Mortalitymentioning

confidence: 99%

Acute retinal arterial ischemia

Dattilo¹,

Newman²,

Biousse³

2018

Ann. Eye Sci

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“…4 Recent studies suggest that RAO is associated with stroke and mortality caused by stroke. [5][6][7][8][9][10][11][12][13][14][15] In the present study, we therefore investigated the possible association between RAO and the subsequent risk of stroke occurrence based on RAO cases and their controls obtained from a nationwide representative sampling of 1 025 340 adults. comprised 1 025 340 nationally representative random subjects, amounting to ≈2.2% of the entire population in the Korean National Health Insurance Service in 2002.…”

mentioning

confidence: 99%

Retinal Artery Occlusion and the Risk of Stroke Development

Rim

Han

Choi

et al. 2016

Stroke

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Background and Purpose— Our aim was to evaluate the risk of subsequent stroke development after retinal artery occlusion (RAO). Methods— National registry data were collected from the Korean National Health Insurance Service, comprised 1 025 340 random subjects. Patients diagnosed with RAO in 2002 and 2003 were excluded. The RAO group was composed of patients with an initial diagnosis of either central or other RAO between January 2004 and December 2013 (n=401). The comparison group was composed of randomly selected patients (5 per RAO patient; n=2003) who were matched to the RAO group according to sociodemographic factors and year of RAO diagnosis. Each sampled patient was tracked until 2013. Cox proportional hazard regression was used. Results— Stroke occurred in 15.0% of the RAO group and in 8.0% of the comparison group ( P < 0.001). RAO was associated with an increased risk of stroke occurrence (hazard ratio, 1.78; 95% confidence interval, 1.32–2.41). The magnitude of the RAO effect for stroke was larger among younger adults aged <65 years (hazard ratio, 3.11) than older adults aged ≥65 years (hazard ratio, 1.26). However, the risk of subsequent stroke was significantly increased in older adults aged ≥65 years at the 4-year follow-up (hazard ratio, 1.58; 95% confidence interval, 1.01–2.48). Conclusions— RAO was significantly associated with subsequent stroke after adjusting for comorbidities and sociodemographic factors. These findings are limited by uncontrolled confounding factors and need to be replicated by other observational studies.

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“…Although the data are largely from small case series, the prevalence of carotid artery disease in those who have CRAO is generally believed to be 10% to 25%, although there is literature suggesting rates as high as 70% [49,[51][52][53][54][55]. Additionally, CRAO in the setting of carotid disease may portend an increased risk for stroke; for this reason, carotid endarterectomy is often recommended in this setting [55].…”

Section: Carotid Artery Atherosclerosismentioning

confidence: 99%