Acute stroke risk in patients with retinal artery occlusion

  • Fallico M & al.
  • Eye (Lond)
  • 16 Sep 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • This meta-analysis showed that 30% of patients with acute central retinal artery occlusion (CRAO) and 25% of patients with acute branch retinal artery occlusion (BRAO) presented an acute cerebral ischaemia on magnetic resonance imaging (MRI) within 7 days of diagnosis.

Why this matters

  • High incidence supports the idea that patients with an acute retinal artery occlusion require an urgent neurological evaluation and brain imaging as part of the clinical management.

Study design

  • Meta-analysis included 6 studies after a search on Pubmed, Medline and Cochrane library.
  • Primary outcome: pooled estimate of incidence rate of acute cerebral ischaemia in CRAO, BRAO and transient monocular vision loss (TMVL) cohorts.
  • Funding: None disclosed.

Key results

  • The pooled estimate of incidence of cerebral ischaemia on MRI in CRAO and BRAO cohort was 0.30 (95% CI, 0.24-0.36) and 0.25 (95% CI, 0.16-0.37), respectively.
  • In the TMVL cohort, acute cerebral ischaemia was detected in 11.8% of cases.
  • The pooled estimate incidence of asymptomatic acute cerebral ischaemia on MRI in CRAO, BRAO and TMVL cohorts was 0.22 (95% CI, 0.16-0.28), 0.29 (95% CI, 0.20-0.41) and 0.08 (95% CI, 0.05-0.15), respectively.

Limitations

  • Risk of bias.
  • Risk of residual cofounding.