Abstract
Purpose :
The association between stroke and retinal vessel occlusive events, particularly central retinal artery occlusion (CRAO) and central retinal vein occlusion (CRVO), is an emerging field with limited existing literature on its link to mortality and the impact of antithrombotic management. This study aims to assess the risk of stroke and mortality within one year before and after the occurrence of CRAO and CRVO, and to explore the influence of antithrombotic treatment (AT) on patient outcomes.
Methods :
This is a retrospective chart review study in a tertiary care hospital setting with the approval of the institutional review board. Subjects were screened using EPIC EMR with ICD codes for CRAO or CRVO diagnosed between 2012 and 2022. Patients eligible were of ages 18-100 years male or female with a diagnosis of CRAO or CRVO. Patients who underwent combined cataract surgery or concurrent surgery for other ophthalmic conditions were excluded. Diagnosis of stroke and antithrombotic data were collected, including the use of thrombolytics, anticoagulants and/or antiplatelets, within +/- one year of occlusive event diagnosis. Chi-Square test was used to analyze the outcomes of stroke one year after occlusive events and all-cause mortality within the groups of AT and no AT pre-diagnosis of CRAO and CRVO.
Results :
A total of 603 subjects meeting eligibility criteria underwent screening, yielding 93 cases of CRAO and 510 cases of CRVO. The participants, with an average age of 69 years, were predominantly female (51%) and belonged mostly to the Caucasian ethnicity. Among those with CRAO, 27.96 % experienced a stroke within one year, with a mortality rate of 13.98%. For CRVO, 6.08% had a stroke within one year, and the mortality rate was 14.71%. Most patients were not on AT before diagnosis, 62.37% for CRAO and 70.78% for CRVO. Treatment with antithrombotics before the diagnosis of either retinal vessel occlusion was not found to reduce the risk of stroke or mortality in patients.
Conclusions :
Preliminary findings from this study suggest that antithrombotic treatment within one year before diagnosis of CRAO or CRVO does not exhibit an association with the development of stroke or mortality. It's important to note that these findings are preliminary, and further analysis is warranted to deepen our understanding of these relationships and refine clinical management strategies.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.