Affiliation:
1. Department of Neurosciences University of Calgary Alberta Canada
2. Southern Alberta Eye Centre University of Calgary Alberta Canada
3. Department of Radiology University of Calgary Alberta Canada
Abstract
Background
Monocular vision loss, attributed to either central retinal artery occlusion (
CRAO
), branch retinal artery occlusion (
BRAO
), or ocular ischemic syndrome (
OIS
), is thought to be associated with an increased prevalence of cerebral infarcts. However, there is a paucity of data substantiating this. We aimed to investigate this relationship in a Canadian center and further understand the importance of associated internal carotid artery stenosis in potential clinical decision making.
Methods and Results
We performed a retrospective cohort study at a comprehensive stroke center of patients presenting initially with
CRAO
,
BRAO
, or
OIS
to a centralized ophthalmology center over a 5‐year period. Patients were followed for 3 years for the occurrence of a hemispheric stroke. We identified 83 affected eyes, with 31
CRAO
, 35
BRAO
, and 17
OIS
patients. Before ocular diagnosis, 32.3%, 11.4%, and 41.2% of
CRAO
,
BRAO
, and
OIS
patients, respectively, experienced a symptomatic stroke. Of the remaining patients, 4.8%, 12.9%, and 40%, respectively, suffered a hemispheric stroke within 3 years of ocular diagnosis. Logistic regressions suggested that for
CRAO
and
BRAO
patients together, the degree of ipsilateral internal carotid artery stenosis is unable to predict the occurrence of a stroke (
P
=0.18), whereas our model correctly predicted a stroke in 82.4% of
OIS
patients (
P
=0.005).
Conclusions
CRAO
,
BRAO
, and
OIS
are associated with significantly increased symptomatic stroke rates. Degree of ipsilateral internal carotid artery stenosis may not be useful in risk stratification for these patients, suggesting that they should be triaged appropriately for stroke risk‐factor management, independent of internal carotid artery stenosis.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Cardiology and Cardiovascular Medicine
Cited by
30 articles.
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