scholarly journals Reply: ‘Central retinal artery occlusion and cerebral stroke’

Eye ◽  
2013 ◽  
Vol 27 (12) ◽  
pp. 1422-1423 ◽  
Author(s):  
A W Lee ◽  
C S Chen ◽  
S Cugati ◽  
D Varma
Stroke ◽  
2021 ◽  
Author(s):  
Brian Mac Grory ◽  
Sean R. Landman ◽  
Paul D. Ziegler ◽  
Chantal J. Boisvert ◽  
Shane P. Flood ◽  
...  

Background: Central retinal artery occlusion (CRAO) causes sudden, irreversible blindness and is a form of acute ischemic stroke. In this study, we sought to determine the proportion of patients in whom atrial fibrillation (AF) is detected by extended cardiac monitoring after CRAO. Methods: We performed a retrospective, observational cohort study using data from the Optum deidentified electronic health record of 30.8 million people cross-referenced with the Medtronic CareLink database of 2.7 million people with cardiac monitoring devices in situ. We enrolled patients in 3 groups: (1) CRAO, (2) cerebral ischemic stroke, and (3) age-, sex-, and comorbidity-matched controls. The primary end point was the detection of new AF (defined as ≥2 minutes of AF detected on a cardiac monitoring device). Results: We reviewed 884 431 patient records in common between the two databases to identify 100 patients with CRAO, 6559 with ischemic stroke, and 1000 matched controls. After CRAO, the cumulative incidence of new AF at 2 years was 49.6% (95% CI, 37.4%–61.7%). Patients with CRAO had a higher rate of AF than controls (hazard ratio, 1.64 [95% CI, 1.17–2.31]) and a comparable rate to patients with stroke (hazard ratio, 1.01 [95% CI, 0.75–1.36]). CRAO was associated with a higher incidence of new stroke compared with matched controls (hazard ratio, 2.85 [95% CI, 1.29–6.29]). Conclusions: The rate of AF detection after CRAO is higher than that seen in age-, sex-, and comorbidity-matched controls and comparable to that seen after ischemic cerebral stroke. Paroxysmal AF should be considered as part of the differential etiology of CRAO, and those patients may benefit from long-term cardiac monitoring.


2014 ◽  
Vol 3 (9) ◽  
Author(s):  
L. Rezaei ◽  
H. Ghanbari ◽  
M. Taghaodi ◽  
M. Malekahmadi ◽  
M. Adinevand ◽  
...  

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Grayson Roumeliotis ◽  
Stewart Campbell ◽  
Sumit Das ◽  
Goran Darius Hildebrand ◽  
Peter Charbel Issa ◽  
...  

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Timothy M. Janetos ◽  
Olga German ◽  
Rukhsana Mirza

Abstract Background A central retinal artery occlusion (CRAO) is an ophthalmic emergency due to its strong association with cerebrovascular and cardiovascular morbidity and mortality. A timely diagnosis is necessary but difficult in the setting of dense asteroid hyalosis, as typical fundoscopic findings can be obscured. We present a case where multimodal imaging in an eye with an obscured fundus could lead to timely diagnosis and management of CRAO in a patient with acute vision loss. Case presentation A 94-year-old Caucasian woman with a history of exudative macular degeneration presented to the retina clinic with acute vision loss in one eye over the course of an afternoon. The patient had dense asteroid hyalosis, and a direct retinal exam was not possible. Multimodal imaging suggested a CRAO diagnosis. The patient received digital ocular massage directly prior to undergoing fluorescein angiography (FANG), which confirmed the diagnosis. The patient was transported from clinic to the emergency room for an emergency stroke workup, which revealed a spontaneous echo in the left atrial appendage, and the patient was started on antiplatelet therapy. When she presented for follow-up within a week, the patient noted that her vision had improved at the time of digital ocular massage and continued to improve thereafter. Her FANG showed marked reperfusion of the retina, and she subsequently has completely regained her baseline visual acuity. Conclusions Multimodal imaging is useful in evaluating visual loss in patients with acute vision loss. In addition, ocular massage is a simple, low-risk intervention that may have benefit in the treatment of acute CRAO. Patients who present to ophthalmologists with an acute CRAO need an emergency referral for evaluation of cerebrovascular and cardiovascular comorbidities.


2001 ◽  
Vol 11 (3) ◽  
pp. 313-315 ◽  
Author(s):  
I.M. Turkistani ◽  
S.A. Ghourab ◽  
O.H. Al-Sheikh ◽  
A.M. Abu El-Asrar

Purpose Ovarian hyperstimulation syndrome (OHSS) is a serious iatrogenic complication of ovulation induction. It is a potentially lethal condition, with severe complications which include ovarian enlargement, and massive fluid redistribution from the vascular system into free spaces resulting in ascites, pleural effusion, electrolyte imbalance, hemoconcentration, hypovolemia, oliguria, and adult respiratory distress syndrome. Thromboembolism is a rare but extremely serious complication. Case Report We report a case of severe OHSS, presenting with central retinal artery occlusion (CRAO). Discussion This combination has not been reported previously.


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