Central retinal artery occlusion as a neuro-ophthalmological emergency: the need to raise public awareness.
Eur J Neurol
; 28(6): 2111-2114, 2021 06.
Article
en En
| MEDLINE
| ID: mdl-33452753
ABSTRACT
BACKGROUND AND PURPOSE:
Central retinal artery occlusion (CRAO) is a neuro-ophthalmological emergency necessitating adequate and comprehensive diagnosis. Its optimal management and treatment, however, are still under debate. This study aimed at identifying respective areas for improvement.METHODS:
We retrospectively analysed the medical records of patients with CRAO treated in our stroke unit between January 2016 and August 2020.RESULTS:
During the observational period, 101 patients with CRAO were admitted. We observed an increase in the rate of patients primarily admitted to the stroke unit from 52.2% to 97.4%. In addition, the thrombolysis rate - with thrombolysis performed on an individual basis - rose from 0% to 14.1%, coinciding with the implementation of an in-hospital management guideline. Almost 60% of all patients presented outside of the 4.5-h time window for thrombolysis; by far the most common reason not to deliver intravenous thrombolysis in our cohort was a prehospital delay to presentation (58.8%), with 44.4% of patients having consulted a private-practice ophthalmologist first. A total of 25 (32.5%) of 77 patients who underwent magnetic resonance imaging (MRI) had accompanying acute ischaemic stroke lesions on diffusion-weighted MRI of the brain. A possible aetiology of CRAO was identified in 41.4% of patients.DISCUSSION:
Public awareness of sudden unilateral visual loss as a presenting sign for stroke should be raised, increasing the chances for timely recognition in a hospital with ophthalmological expertise and a stroke centre. This is essential for ongoing and future prospective trials on this subject.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Oclusión de la Arteria Retiniana
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Isquemia Encefálica
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Accidente Cerebrovascular
Tipo de estudio:
Guideline
/
Observational_studies
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Qualitative_research
Límite:
Humans
Idioma:
En
Año:
2021
Tipo del documento:
Article