The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques · 2025
Central Retinal Artery Occlusion at a Canadian Academic Center.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Quinn Matthew P, Liu Victoria, Albreiki Danah, Lelli Daniel A
Аннотация
BACKGROUND: Central retinal artery occlusion (CRAO) is a retinal stroke with poor visual prognosis and frequent association with life-threatening conditions. Clinical guidelines and treatment options are in evolution, and Canadian data regarding CRAO are limited.
METHODS: Patients with CRAO between June 1, 2019, and May 31, 2023, were included. The medical chart was reviewed for demographics, presentation factors, investigations, interventions, secondary prevention referrals and outcomes.
RESULTS: Seventy-six patients were included. Median age was 68.1 (61.4-81.8) years, and 60.5% were male. The site of presentation was an emergency department in 61.8%. The median (interquartile range [IQR]) time from vision loss to presentation was 15.0 (3.5-48.0) hours; 28.9% presented within 4.5 hours. The median (IQR) time for ophthalmological consultation was 12.0 (4.6-22.6) hours. No patient was treated with thrombolysis. Referral for neurovascular secondary prevention occurred for 92.1%; however, referral for ocular follow-up was omitted in 21.1%. Among patients with non-arteritic CRAO, 25.7% had symptomatic carotid stenosis, and 10.5% had a cardioembolic source. Giant cell arteritis was diagnosed in 8.1% of patients over age 50. Functional visual recovery occurred for 10.5% of patients.
CONCLUSIONS: In this series, patients often presented within hours of CRAO and usually to an emergency department; however, no patient was treated with thrombolysis. As in other centers, delay in ophthalmological consultation and the lack of a defined CRAO treatment pathway are barriers. Patients with CRAO frequently have high-risk underlying pathology and generally do not experience meaningful improvement in vision. There is an unmet need for Canadian guidelines to standardize multidisciplinary care for CRAO.
METHODS: Patients with CRAO between June 1, 2019, and May 31, 2023, were included. The medical chart was reviewed for demographics, presentation factors, investigations, interventions, secondary prevention referrals and outcomes.
RESULTS: Seventy-six patients were included. Median age was 68.1 (61.4-81.8) years, and 60.5% were male. The site of presentation was an emergency department in 61.8%. The median (interquartile range [IQR]) time from vision loss to presentation was 15.0 (3.5-48.0) hours; 28.9% presented within 4.5 hours. The median (IQR) time for ophthalmological consultation was 12.0 (4.6-22.6) hours. No patient was treated with thrombolysis. Referral for neurovascular secondary prevention occurred for 92.1%; however, referral for ocular follow-up was omitted in 21.1%. Among patients with non-arteritic CRAO, 25.7% had symptomatic carotid stenosis, and 10.5% had a cardioembolic source. Giant cell arteritis was diagnosed in 8.1% of patients over age 50. Functional visual recovery occurred for 10.5% of patients.
CONCLUSIONS: In this series, patients often presented within hours of CRAO and usually to an emergency department; however, no patient was treated with thrombolysis. As in other centers, delay in ophthalmological consultation and the lack of a defined CRAO treatment pathway are barriers. Patients with CRAO frequently have high-risk underlying pathology and generally do not experience meaningful improvement in vision. There is an unmet need for Canadian guidelines to standardize multidisciplinary care for CRAO.