CRAO patients at high risk for undiagnosed cardiovascular risk factors

A complete work-up immediately following nonarteritic central retinal artery occlusion (NA-CRAO) picks up undiagnosed cardiovascular risk factors in almost 80% of patients, according to a study in Ophthalmology.

While it’s known that cardiovascular risk factors are more prevalent in CRAO patients compared with age-matched controls, there are no prospective data from homogeneous patient groups from which to analyze the underlying cardiovascular risk factors.

To address this deficit, the authors conducted a secondary analysis of a randomized, controlled trial – the European Assessment Group for Lysis in the Eye (EAGLE) study – that enrolled 77 patients, aged 18 to 75, with NA-CRAO symptoms lasting fewer than 20 hours.

The authors made 3 key findings:

• A prompt work-up identified at least 1 previously undiagnosed risk factor for cardiovascular disease in 78% of CRAO patients.
• Among undiagnosed risk factors, ipsilateral carotid artery stenosis was the most common, occurring in 40% of patients, but it was diagnosed in only 3% of patients before the event.
• Carotid ultrasound appears the most relevant diagnostic procedure in CRAO patients.

Additionally, of the 77 study subjects, 11 had a stroke after the event, with 5 of those occurring within 4 weeks after the arterial occlusion.

The authors recommend prompt diagnostic workup for all NA-CRAO patients.