Abstract
Abstract: :
Purpose: To describe statin use in patients with central retinal artery occlusions (CRAO). Methods: Retrospective case series of 23 eyes of 21 patients diagnosed with CRAO at Scheie Eye Institute between September 1993 and September 2004. Patients with CRAO due to inflammatory conditions (such as giant cell arteritis) were excluded. Results: Nine male and thirteen female patients with an average age of 70.6 years (range = 56 – 84 years) were diagnosed with CRAO. Two patients developed CRAO in the second eye at a later time. No follow–up was available for three eyes. Average follow–up for the remaining 20 eyes was 185.6 weeks (range = 1 – 581 weeks). Presenting visual acuity was poor (hand motions or worse) in 6 eyes, functional (CF to < 20/100) in 15 eyes, and good (20/100 or better) in 2 eyes. Final visual acuity was poor in 6 eyes, functional in 8 eyes, and good in 6 eyes. At the time of diagnosis, only five of the 21 patients (23.8%) were on a statin. All five of these eyes had presenting visual acuities in the functional range. Final visual acuity in the 4 eyes with follow–up was poor in 1 eye, functional in 2 eyes, and good in 1 eye. During follow–up, five of the remaining 16 patients (31.3%) were started on a statin. One of these five was a patient with fellow eye involvement who was started on a statin only after the second CRAO. Eleven of the 21 patients (52.4%) were not started on a statin during the follow–up period. Conclusions: In reviewing the stroke literature, some studies have demonstrated a benefit of statin use in preventing other major vascular events in patients who have experienced a stroke. Moreover, at least one study (MRC/BHF Heart Protection Study) demonstrated that this benefit occurred irrespective of cholesterol level in high–risk patients, including those with prior cerebrovascular disease, coronary disease, diabetes mellitus, or hypertension. Since most cases of CRAO are essentially stroke equivalents, these patients may also benefit from statins to help reduce the risk of future major vascular events.
Keywords: vascular occlusion/vascular occlusive disease • retina