Protocol shows potential for rapid diagnosis of retinal artery occlusion
Click Here to Manage Email Alerts
Key takeaways:
- The mean time to treatment was 2.5 hours after presentation.
- Initial outcomes demonstrated significant improvement in visual acuity after treatment with intra-arterial tissue plasminogen activator.
A novel protocol utilizing OCT imaging and a remote consult model showed promise in rapidly diagnosing retinal artery occlusion, according to a study published in Ophthalmology.
“We developed a novel clinical diagnostic protocol using a remote consult model to streamline the identification of [retinal artery occlusions] at the point of care,” the authors wrote. “The initial outcomes have demonstrated significant improvement in visual acuity and show that efforts to incorporate remote ophthalmology consultation can facilitate the diagnosis of emergency ophthalmic conditions.”
The protocol was implemented at three hospitals in the Mount Sinai Health System, with OCT machines placed in the stroke center or emergency department. The main outcomes measures of the study were visual acuity before and after treatment with intra-arterial tissue plasminogen activator (IA-tPA), time from “last known well” to treatment, and time from presentation to treatment.
Fifty-nine patients who presented with painless monocular vision loss underwent the protocol in the first 18 months of its launch. Based on OCT and follow-up exam, 42% had a confirmed retinal artery occlusion. Nine out of 10 eligible patients received treatment with IA-tPA.
Mean visual acuity statistically significantly improved from logMAR 2.14 to logMAR 0.7 within 24 hours of treatment (P = .0001) and to logMAR 1.04 after 4 weeks (P = .01). In addition, 66% of patients experienced clinically significant improvement from worse to 20/200 to 20/100 or better within 24 hours, which was maintained in 56% of patients at 1 month.
The mean time to treatment was about 9 hours from the onset of symptoms and about 2.5 hours after presentation.
“The primary goal of this clinical protocol was to reduce the time to treatment for retinal artery occlusions,” the authors wrote. “However, we realize that the implications of this study firmly support the use of ophthalmic imaging in acute care settings for rapid remote consultation of most ophthalmic conditions.”
Reference:
- Mount Sinai ophthalmologists develop novel protocol to rapidly diagnose and treat eye stroke.
- https://www.mountsinai.org/about/newsroom/2024/mount-sinai-ophthalmologists-develop-novel-protocol-to-rapidly-diagnose-and-treat-eye-stroke
- Published Feb. 13, 2024. Accessed Feb. 13, 2024.
Collapse
Read more about
Click Here to Manage Email Alerts