Co-occurrence of acute retinal artery occlusion and acute ischemic stroke: diffusion-weighted magnetic resonance imaging study.

Abstract:

PURPOSE:To evaluate the co-occurrence of acute ischemic stroke and acute retinal artery occlusion (RAO). DESIGN:Retrospective observational case series. METHODS:We included 33 consecutive patients with acute RAO who underwent diffusion-weighted magnetic resonance imaging within 7 days of the onset of visual symptoms. The causes of RAO were classified according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria, which are based on clinical features and the results of etiological evaluations for atherosclerosis, cardioembolism and other prothrombotic conditions. We evaluated the prevalence of accompanying acute ischemic stroke in subjects with acute RAO and examined the relationships with etiological parameters. RESULTS:Acute ischemic stroke was detected in 8 (24.2%) subjects with RAO. Among these subjects, 3 (37.5%) patients did not exhibit any neurologic symptoms or signs. Most of the infarction patterns were small, multiple and scattered. All of the subjects with RAO who were positive for lesions on diffusion-weighted imaging had identifiable causes, whereas only 36% of the subjects who were negative for lesions had identifiable etiologies (P = .003). Carotid stenosis or cardioembolic sources were found more commonly in cases of central retinal artery occlusion (CRAO; 7/18, 38.9%) than in cases of branch retinal artery occlusion (BRAO; 1/15 6.7%, P = .046). CONCLUSIONS:Acute cerebral infarctions frequently accompany RAO. We recommend diffusion-weighted imaging for patients with RAO because the presence of lesions on diffusion-weighted imaging is accompanied by a significantly increased probability of identifying the cause.

journal_name

Am J Ophthalmol

authors

Lee J,Kim SW,Lee SC,Kwon OW,Kim YD,Byeon SH

doi

10.1016/j.ajo.2014.01.033

subject

Has Abstract

pub_date

2014-06-01 00:00:00

pages

1231-8

issue

6

eissn

0002-9394

issn

1879-1891

pii

S0002-9394(14)00063-4

journal_volume

157

pub_type

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