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Previously undiagnosed cardiovascular risk factors found in many patients with CRAO
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A high percentage of patients with nonarteritic central retinal artery occlusion had pre-existing or newly diagnosed cardiovascular risk factors, according to a study.
“We consider CRAO patients at high risk for future vascular events and recommend a comprehensive diagnostic work-up in all patients with CRAO,” the study authors said.
Data were culled from the European Assessment Group for Lysis in the Eye (EAGLE) study. The prospective subanalysis included 77 patients with nonarteritic central retinal artery occlusion (CRAO).
Upon entering the study, patients answered a standardized questionnaire concerning medical history. Standardized medical and neurologic examination included carotid Doppler ultrasonography, echocardiography, electrocardiography, blood pressure monitoring, pulse rate, urine analysis, BMI and laboratory testing.
Fifty-two patients (67%) had a history of cardiovascular risk factors. At least one previously undiagnosed risk factor was found in 60 patients (78%).
Carotid artery stenosis of at least 70% was found in 31 patients (40%).
Eleven patients had a stroke, with five of those happening 4 weeks or fewer after CRAO occurred.
Pre-existing arterial hypertension was found in 44 patients (57%) and newly diagnosed in 12 patients (16%). Coronary artery disease was pre-existing in five patients (6%) and newly diagnosed in 12 patients (16%). Heart failure was pre-existing in three patients (4%) and newly diagnosed in one patient (1%).
BMI was more than 25 kg/m2 in 45 patients (82%) and more than 30 kg/m2 in 15 patients (27%).
Thirty-eight patients (49%) were active or former smokers. – by Matt Hasson
Disclosure: The authors report no relevant financial disclosures.
Perspective
Back to TopJay S. Duker, MD
This paper analyzed the cardiovascular risk factors from the cohort of patients who were enrolled in a multicenter prospective trial of thrombolysis for central retinal artery obstruction (CRAO), the EAGLE study.The study found that in the 77 evaluable patients who had suffered an acute CRAO and were enrolled, exactly two-thirds had at least one pre-existing cardiovascular risk factor, including 40% with significant carotid artery stenosis. However, 78% were found to have at least one previously undiagnosed cardiovascular risk factor, many of which were potentially life threatening. This study highlights the importance of doing prompt and complete systemic evaluations in patients who present with acute CRAO.
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Callizo J, et al. Ophthalmology. 2015;doi:10.1016/j.ophtha.2015.05.044.
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