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Am J Ophthalmol. 2019 Apr;200:179-186. doi: 10.1016/j.ajo.2019.01.009. Epub 2019 Jan 26.

Acute Vascular Ischemic Events in Patients With Central Retinal Artery Occlusion in the United States: A Nationwide Study 2003-2014.

Author information

1
Department of Ophthalmology & Visual Science, Yale School of Medicine, New Haven, Connecticut, USA; West Virginia University School of Medicine, Morgantown, West Virginia, USA. Electronic address: tahreemaman2013@gmail.com.
2
West Virginia University School of Medicine, Morgantown, West Virginia, USA.
3
West Virginia Clinical and Translational Science Institute, WVU Health Sciences Center Erma Byrd Biomedical Research Center, Morgantown, West Virginia, USA.

Abstract

PURPOSE:

Central retinal artery occlusion (CRAO) confers a high risk of acute vascular ischemic events, including stroke and myocardial infarction (MI). Understanding the burden and risk factor profile of these ischemic events can serve as a valuable guide for ophthalmologists in the management and appropriate referral of these patients.

DESIGN:

Retrospective cross-sectional study.

METHODS:

The Nationwide Inpatient Sample (NIS) was queried to identify all inpatient admissions with a diagnosis of CRAO in the United States between the years 2003 and 2014. The primary outcome measure was the incidence of in-hospital acute vascular ischemic events.

RESULTS:

There were an estimated 17 117 CRAO inpatient admissions. The mean age was 68.4 ± 0.1 years and 53% of patients were female. The incidence of in-hospital stroke and acute MI were 12.9% and 3.7%. The incidence of stroke showed an increasing trend over the years, almost doubling in 2014 in comparison to 2003 (15.3% vs 7.7%). The combined risk of in-hospital stroke, transient ischemic attack, acute MI, or mortality was 19%. Female sex, hypertension, carotid artery stenosis, aortic valve disease, smoking, and alcohol dependence or abuse were positive predictors of in-hospital stroke.

CONCLUSION:

There is a significant burden of vascular risk factors, associated with an increased risk of in-hospital stroke, acute MI, and death in CRAO patients. The risk of CRAO-associated stroke is highest in women and in those with a history of hypertension, carotid artery stenosis, aortic valve disease, smoking, or alcohol abuse.

PMID:
30689989
PMCID:
PMC6542256
[Available on 2020-04-01]
DOI:
10.1016/j.ajo.2019.01.009

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