Symptomatic and asymptomatic retinal embolism have different mechanisms.

Abstract:

PURPOSE:To investigate differences between symptomatic and asymptomatic retinal embolism regarding the frequency and source of cerebral microemboli. METHODS:Thirty-seven patients with transient monocular blindness or retinal infarction and 27 patients (29 eyes) with asymptomatic retinal embolism were prospectively enrolled. Patients underwent a transcranial Doppler study and noninvasive imaging of the cervical internal carotid arteries (ICA). The middle cerebral artery (MCA) ipsilateral to the affected eye was monitored for 30 minutes for microembolic signals (MES), which were saved and analyzed offline. Age-matched controls (n=15) had no history of retinal or brain ischemia, <50% ICA stenosis, and normal ophthalmologic examinations. RESULTS:MES were detected in 0/15 (0%) controls, 11/37 (30%) MCAs in the symptomatic group (P=0.02), and 3/29 (10%) MCAs in the asymptomatic group (P=0.54). Nine of 11 (82%) symptomatic eyes with MES had ipsilateral ICA stenosis of > or =50%, as compared with 0/3 (0%) eyes in the asymptomatic group with MES (P=0.03). Both MES and ICA stenosis of >50% were present in 9/37 (24%) cases in the symptomatic and in 0/29 (0%) cases of the asymptomatic group (P=0.0036). CONCLUSIONS:The frequency and potential source of cerebral microemboli in symptomatic and asymptomatic retinal embolism are different. Cerebral microemboli are more frequent in symptomatic patients and are associated with ICA stenosis.

journal_name

Stroke

journal_title

Stroke

authors

Wijman CA,Gomes JA,Winter MR,Koleini B,Matjucha IC,Pochay VE,Babikian VL

doi

10.1161/01.STR.0000125009.05353.7c

subject

Has Abstract

pub_date

2004-05-01 00:00:00

pages

e100-2

issue

5

eissn

0039-2499

issn

1524-4628

pii

01.STR.0000125009.05353.7c

journal_volume

35

pub_type

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