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

Junwon Lee, Seung Woo Kim, Sungchul Lee, Oh Woong Kwon, Young Dae Kim, Suk Ho Byeon

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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.

Original languageEnglish
Pages (from-to)1231-1238
Number of pages8
JournalAmerican Journal of Ophthalmology
Volume157
Issue number6
DOIs
Publication statusPublished - 2014 Jan 1

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Retinal Artery Occlusion
Diffusion Magnetic Resonance Imaging
Stroke
Carotid Stenosis
Cerebral Infarction
Neurologic Manifestations
Infarction
Atherosclerosis

All Science Journal Classification (ASJC) codes

  • Ophthalmology

Cite this

Lee, Junwon ; Kim, Seung Woo ; Lee, Sungchul ; Kwon, Oh Woong ; Kim, Young Dae ; Byeon, Suk Ho. / Co-occurrence of acute retinal artery occlusion and acute ischemic stroke : Diffusion-weighted magnetic resonance imaging study. In: American Journal of Ophthalmology. 2014 ; Vol. 157, No. 6. pp. 1231-1238.
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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.",
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Co-occurrence of acute retinal artery occlusion and acute ischemic stroke : Diffusion-weighted magnetic resonance imaging study. / Lee, Junwon; Kim, Seung Woo; Lee, Sungchul; Kwon, Oh Woong; Kim, Young Dae; Byeon, Suk Ho.

In: American Journal of Ophthalmology, Vol. 157, No. 6, 01.01.2014, p. 1231-1238.

Research output: Contribution to journalArticle

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