Retinal artery occlusion may be associated with higher risk of stroke
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Retinal artery occlusion of all types is associated with significantly increased risk of stroke, which is higher in the period immediately adjacent to the event, according to two studies based on data from a large medical claims database.
“A survey in 2014 showed that only 18% of U.S. retina specialists and 73% of neurologists send CRAO patients to the ED for emergent workup, and little evidence currently exists for the association of BRVO to stroke,” Brian L. VanderBeek, MD, MPH, said at the virtual American Academy of Ophthalmology annual meeting.
To determine whether the occurrence of retinal artery occlusion (RAO) increases the near-term risk of having a stroke, a self-controlled case series (SCCS) and a propensity score (PS) matched cohort study were performed. The Clinformatics Data Mart Database (OptumInsight) was used, including the medical and sociodemographic information of more than 60 million insured U.S. citizens.
Results of the 30-day SCCS study showed that the 16,193 patients with RAO had a 3.37 increased risk ratio of stroke in that time span compared with the 6-month period before the event. In the 7 days immediately following the occurrence of RVO, the risk was significantly higher than in the following weeks.
“There is a clear trend that the further away from the initial period after the RAO, the less the risk there is of having a stroke,” VanderBeek said.
In the PS matched cohort study, 18,000 RAO patients were matched to an equal number of hip fracture patients. Patients in the RAO group who had a stroke within the first year were 1,807 compared with only 606 in the hip fracture group, resulting in a 2.97 increased risk ratio.
“Our findings support the idea that emergent referral to the ED is necessary for future stroke prevention,” VanderBeek said.
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VanderBeek BL, et al. Retinal artery occlusion and stroke. Presented at: American Academy of Ophthalmology annual meeting; Nov. 13-15, 2020 (virtual meeting).
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