gms | German Medical Science

Background and Purpose: To prospectively evaluate cardio-vascular risk factors in a well defined group of patients suffering from acute central retinal artery occlusion (CRAO) not older than 20 hours.

Methods: As part of the European Assessment Group for Lysis in the Eye (EAGLE) trial the data of 84 patients were analyzed. In this study intraarterial fibrinolysis was compared to a non-interventional therapy in patients with an acute CRAO not older than 20 hours. Pre-existing diseases and risk factors were collected at the time of inclusion. Detailed neurologic and cardiologic examination was performed after initial therapy to establish the cause of the occlusion. Amongst others patients were investigated by echocardiography, sonography of extracranial arteries, and laboratory parameters.

Results: Known pre-existing risk factors were elevated blood pressure (n=42/58%), stenosis of the carotid arteries (n=2/3%), hypercholesterolemia (n=5/7%), cigarette smoking (n=32/45%), heart failure like arrhythmia (n=4/6%), and cardiac valvula diseases (n=5/7%). New diagnosed risk factors were elevated blood pressure in 12 patients (17%), stenosis of the carotid arteries (n=29/40%), hypercholesterolemia (n=24/33%), heart failure like arrhythmia (n=5/7%), ischemic stroke (n=1/1%), haemorrhagic stroke (n=238%), and cardiac valvular diseases (n=17/24%). The highest correlation between CRAO and new identified risk factors was found for ipsilateral carotid artery stenosis.

Conclusions: Sonography of the extracranial arteries and echocardiography are the most important instrument to evaluate patients' cardiovascular risk during a neurologic and cardiologic examination and must be recommended for all patients after acute CRAO.