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A. Feldman, P.-L. Cornut, M. De Bats, C. Burillon, P. Denis; Anterior Ischemic Optic Neuropathy and Retinal Artery Occlusion: Check-Up Interest During Hospitalization. Invest. Ophthalmol. Vis. Sci. 2009;50(13):4029.
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To evaluate a standard check-up during hospitalization for patients presenting anterior ischemic optic neuropathy (AION) or retinal artery occlusion (RAO).
It was a prospective study. The standard check-up was the following one: ESR, CRP, CBC (on emergency), PT, aPTT, fibrinogen, antiphospholipid antibodies, serum protein electrophoresis, homocysteinemia, fasting blood sugar, HbA1c, cholesterol, triglycerides, ambulatory blood pressure monitoring, carotid doppler ultrasound, echocardiography, ECG, cardiologic visit, brain MRI or CT, visual field, fluorescein angiography and temporal artery biopsy at the slightest clinical sign of giant cell arteritis.
46 patients were included. Mean age was 73 years (47-92). CRAO occured in 19 patients (41.3%), BRAO in 6 (13%) and AION in 21 (45.7%). Mean hospitalization duration was 8 days (2-22). AION was bilateral in 2 cases. 6 patients had no atherosclerotic risk factor. Risk factors were already balanced in 11 cases of 46 (23.9%). In 13 cases, a therapic modification has been made to balance risk factors. Corticotherapy has been started in 8 cases (6 AION, 2 RAO); giant cell arteritis was proved in 2 cases (2 AION) and highly suspected in 6 cases. In 8 cases (17.4%), the patient had to be transfered in another specialized service while he was hospitalized (internal medicine, cardiovascular, resuscitation). In 63% of the cases, standard check-up realized during hospitalization led to a change of treatment. Underlying disease was potentially serious and needed an urgent care in a great number of cases.
Standard check-up during hospitalization allowed in this study a rapid multidisciplinary care adapted to RAO and AION. A therapeutic change has been established in 2 cases out of 3 and almost 1 patient out of 5 has been transfered in a specialized service.
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