Patients with central retinal artery occlusion (CRAO) are at significant risk for stroke as well critical cardiovascular events.

A recent study evaluated systematic risk factors in 103 individuals with acute CRAO. Researchers believed that CRAO was mechanistically similar to a stroke, so they conducted a standardized and systematic evaluation of risk factors similar to those used on those who have had a stroke. The risk factors included critical carotid disease, coincident acute stroke, hypertensive emergency, myocardial infarction and critical structural cardiac disease. Researchers also evaluated the rate of symptomatic stroke, myocardial infarct and death risk in the 24 months after occlusion.

In the cohort analyzed, 36.7% of patients had critical carotid disease, 37.3% had coincident acute stroke, 33.0% presented with hypertensive emergency, 20.0% had a myocardial infarction or critical structural cardiac disease, 25% underwent an urgent surgical intervention and 93% had a change in medication as a result of the evaluation.

The study determined that patients with CRAO had the same risk of subsequent stroke, myocardial infarction and death as patients with high-risk transient ischemic attack.

Lavin P, Patrylo M, Hollar M, Espaillat KB, Kirshner H, Schrag M. Stroke risk and risk factors in patients with central retinal artery occlusion. Am J Ophthalmol. August 25, 2018. [Epub ahead of print].