Purchase this article with an account.
Michael Ward, Justin Etzel, Samantha Sauerzopf, Gordon Crabtree; Retinal Artery Occlusions and Risk Factors in the Young. Invest. Ophthalmol. Vis. Sci. 2021;62(8):3200.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Retinal artery occlusions (RAOs) are rare and understudied in young patients, and the etiology of these events are thought to differ from older adults. We performed a retrospective, observational study to investigate risk factors associated with RAOs in young adults.
A retrospective chart review of patients under 40 was conducted of the medical record from 1/1/2003 through 10/28/2019. Patients were identified by the ICD-9/ICD-10 codes for central retinal artery occlusion (CRAO), branch retinal artery occlusion (BRAO), and partial retinal artery occlusion. Clinical data was obtained by manual chart review.
30 eyes from 28 patients were identified with a RAO. 8 patients were found to have CRAO, 19 had BRAO, and two patients had a hemiretinal artery occlusion. The average age at onset was 33.14 years. 71.4% of patients were female, and only 10.7% were non-White.Systemic risk factors were discovered in 25 patients (89.3%), with 12 patients (42.9%) having a hypercoagulable state, 4 patients (14.3%) having a rheumatologic condition without hypercoagulability, 3 patients (10.7%) with significant cardiac risk factors, and 2 patients (7.1%) whose only risk factor was hormonal contraceptive use. One traumatic and one post-operative RAO were identified. One patient was diagnosed with Susac Syndrome.6 patients (21.4%) were smokers at onset of the RAO. A large percentage of affected patients were overweight, with 14 patients (50%) having BMI >25, and 11 (39.3%) with BMI >30.Two patients (7.14%) died within 1 year of RAO onset, and a third patient passed approximately 8 years after RAO onset.
Retinal artery occlusion in young adults is rare. Unlike the embolic nature in older adults, hypercoagulable conditions, such as Lupus,are frequently found in younger patients and is the most common etiology in this study. Conditions associated with vaso-occlusive events such as smoking, hormonal contraceptive use, and cardiovascular disease were less common.A third of the patients were obese/morbidly obese, hinting at a possible association with RAO. Additionally, clinically significant vaso-occlusive events leading to death occurred in several patients after RAO. This may suggest that RAO in young adults may be a harbinger of poor outcomes. However, due to the extreme rarity of this disease entity, further study is required to draw definitive conclusions.
This is a 2021 ARVO Annual Meeting abstract.
Demographics, Systemic Abnormalities, and Ocular Findings
This PDF is available to Subscribers Only