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E. Sharkawi, J. F. Bacon, F. H. Zaidi, K. Gregory-Evans; Seconadry Ischemic Events Following Non-Arteritic Retinal Artery Ischaemia in Four Uk Centres. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3083.
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To determine the type and rate of secondary ischemic events following acute non-arteritic retinal artery ischemia.
The medical records of a consecutive series of 163 patients with acute retinal arterial occlusion and amaurosis fugax (AFx) were reviewed in four UK Ophthalmology centers and data extracted
The mean age of patients was 65 years, 58% were male, 20 patients (12.3%) suffered secondary ischemic events. 14 (70.0%) of these occurred within 2 months of the initial retinal event. These included 3 myocardial infarctions, 2 episodes of unstable angina requiring hospitalisation, 4 cerebral TIAs, 1 cerebral stroke, 7 further retinal artery occlusions, 2 retinal vein occlusions and 1 further episode of amaurosis fugax. Iris neovascularisation, occurred in 12% of patients, 8 to 32 weeks following central retinal artery occlusion.
The rate of secondary ischemic events following retinal arterial ischemia was higher than expected. In contrast to previous studies, an Ophthalmologist examined all patients diagnosed with retinal artery occlusion and AFx. The majority of secondary events occurred in the early post retinal stroke/TIA period. These results are consistent with cerebral stoke data and highlight the importance of urgent treatment and rapid referral of these high-risk patients, who often first present to the Ophthalmologist.
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