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. 2019 Apr:200:179-186.
doi: 10.1016/j.ajo.2019.01.009. Epub 2019 Jan 26.

Acute Vascular Ischemic Events in Patients With Central Retinal Artery Occlusion in the United States: A Nationwide Study 2003-2014

Tahreem A Mir  1 , Ahmad Z Arham  2 , Wei Fang  3 , Fahad Alqahtani  2 , Mohamad Alkhouli  2 , Julia Gallo  2 , David M Hinkle  2
Affiliations

Acute Vascular Ischemic Events in Patients With Central Retinal Artery Occlusion in the United States: A Nationwide Study 2003-2014

Tahreem A Mir et al. Am J Ophthalmol. 2019 Apr.

Abstract

Purpose: Central retinal artery occlusion (CRAO) confers a high risk of acute vascular ischemic events, including stroke and myocardial infarction (MI). Understanding the burden and risk factor profile of these ischemic events can serve as a valuable guide for ophthalmologists in the management and appropriate referral of these patients.

Design: Retrospective cross-sectional study.

Methods: The Nationwide Inpatient Sample (NIS) was queried to identify all inpatient admissions with a diagnosis of CRAO in the United States between the years 2003 and 2014. The primary outcome measure was the incidence of in-hospital acute vascular ischemic events.

Results: There were an estimated 17 117 CRAO inpatient admissions. The mean age was 68.4 ± 0.1 years and 53% of patients were female. The incidence of in-hospital stroke and acute MI were 12.9% and 3.7%. The incidence of stroke showed an increasing trend over the years, almost doubling in 2014 in comparison to 2003 (15.3% vs 7.7%). The combined risk of in-hospital stroke, transient ischemic attack, acute MI, or mortality was 19%. Female sex, hypertension, carotid artery stenosis, aortic valve disease, smoking, and alcohol dependence or abuse were positive predictors of in-hospital stroke.

Conclusion: There is a significant burden of vascular risk factors, associated with an increased risk of in-hospital stroke, acute MI, and death in CRAO patients. The risk of CRAO-associated stroke is highest in women and in those with a history of hypertension, carotid artery stenosis, aortic valve disease, smoking, or alcohol abuse.

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Figures

FIGURE 1
FIGURE 1
Temporal trends of in-hospital acute ischemic events in central retinal artery occlusion in the United States population: A) Acute stroke; B) Transient ischemic attack; C) Acute myocardial infarction; D) Died during hospitalization.
FIGURE 2
FIGURE 2
Economic burden associated with central retinal artery occlusion hospitalizations in the United States: A) Total number of admissions and inflation-adjusted charges per year; B) Mean inflation-adjusted charge per hospital admission.
See this image and copyright information in PMC

References

    1. Hayreh SS, Zimmerman MB. Central retinal artery occlusion: visual outcome. Am J Ophthalmol 2005;140(3):376–391. - PubMed
    1. Hayreh SS, Podhajsky PA, Zimmerman MB. Retinal artery occlusion: associated systemic and ophthalmic abnormalities. Ophthalmology 2009;116(10):1928–1936. - PMC - PubMed
    1. Savino PJ, Glaser JS, Cassady J. Retinal stroke. Is the patient at risk? Arch Ophthalmol 1977;95(7):1185–1189. - PubMed
    1. Schumacher M, Schmidt D, Jurklies B, et al. Central retinal artery occlusion: local intra-arterial fibrinolysis versus conservative treatment, a multicenter randomized trial. Ophthalmology 2010;117(7):1367–1375.e1361. - PubMed
    1. Chen CS, Lee AW, Campbell B, et al. Efficacy of intravenous tissue-type plasminogen activator in central retinal artery occlusion: report from a randomized, controlled trial. Stroke 2011;42(8):2229–2234. - PubMed

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