Stroke may occur before/after central retinal artery occlusion

A 2.2-percent risk of symptomatic ischaemic stroke has been observed 15 days before and after a central retinal artery occlusion (CRAO), suggests a recent study, noting that such risk is slightly lower than that for most studies from tertiary centres.

The authors performed a population-based, retrospective case series to determine the risk of stroke, transient ischaemic attack (TIA), and transient monocular vision loss (TMVL) before and after a CRAO. Patients diagnosed with a CRAO in Olmsted County, Minnesota, in the US from 1976 to 2016 were included in the review.

The authors confirmed new CRAOs and recorded stroke, TIA, and TMVL events in the 15 days prior to and following CRAO (main outcome measures).

Eighty-nine patients with a CRAO (median age at time of CRAO 76 years, 56.2 percent male, 89.9 percent White) were identified, with an annual incidence of 2.58 per 100,000 (95 percent confidence interval, 2.04‒3.11).

Two ischaemic strokes (2.2 percent), one haemorrhagic stroke (1.1 percent), two TIAs (2.2 percent), and nine TMVL events occurred in the 15 days before and after a CRAO. Within 2 months of CRAO, 15 of 45 patients underwent magnetic resonance imaging since 1999. One patient (6.7 percent) showed evidence of asymptomatic diffusion restriction, while nine (60 percent) had a remote infarct.

“These data should be considered as practice recommendations … regarding the urgency of neurovascular workup in patients with acute CRAO,” the authors said.