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Referral Patterns of Central Retinal Artery Occlusion to an Academic Center Affiliated With a Stroke Center
Background: Central retinal artery occlusion (CRAO) is a medical emergency, and patients who present acutely should be immediately referred to the nearest stroke center. We evaluated practice patterns for CRAO management at one academic center over the last decade. Methods: This was a retrospective study on all adult patients diagnosed with a CRAO seen at one tertiary hospital and outpatient clinic affiliated with a comprehensive stroke center (“our institution”) from 2010 to 2020. Our electronic medical records were searched for CRAO diagnoses, and patient medical records were reviewed. The exclusion criter...
Source: Journal of Neuro-Ophthalmology - November 22, 2021 Category: Opthalmology Tags: Original Contribution Source Type: research

The Frequency of Carotid Intraplaque Hemorrhage on Vessel Wall Imaging in Patients With Retinal Artery Occlusion: A Cross-Sectional Prevalence Study
Conclusions: Carotid IPH is independently associated with RAO. The use of plaque imaging in the evaluation of patients with acute RAO is therefore supported.
Source: Journal of Neuro-Ophthalmology - November 22, 2021 Category: Opthalmology Tags: Original Contribution Source Type: research

SARS-CoV-2 Impairs Vision
Conclusions: This mini review shows that impaired vision may be the initial manifestation of COVID-19, that all sections of the visual tract may be affected and causative for visual impairment in COVID-19 patients, and that SARS-CoV-2 manifests along the visual tract with ischemia, focal infection, and immunological reactions.
Source: Journal of Neuro-Ophthalmology - June 1, 2021 Category: Opthalmology Tags: Disease of the Year: COVID-19 Source Type: research

Secondary Stroke Prevention and Management for the Neuro-Ophthalmologist
Conclusions: The optimal treatment to prevent stroke recurrence is determined by the etiology of stroke. After stroke workup, patients will typically be placed on proper medical therapy for the appropriate duration in addition to counseling on lifestyle modifications to reduce the risk of recurrent strokes. For complex patients, it is reasonable for providers to consider patient referral to stroke specialists for further aid in selection of appropriate medical therapy.
Source: Journal of Neuro-Ophthalmology - November 22, 2020 Category: Opthalmology Tags: Disease of the Year 2020: Cerebrovascular Disorders Source Type: research

Thrombolysis for Central Retinal Artery Occlusion in 2020: Time Is Vision!
Conclusions: In 2020, nonarteritic CRAO patients should theoretically receive the same thrombolytic therapies, in the same time window, as patients with acute cerebral ischemia. Eye stroke and teleeye stroke code encounters must include an expert ophthalmologic evaluation to confirm the correct diagnosis and to evaluate for ocular signs that may help guide IV tPA administration or IA management. Future research should focus on developing feasible retinal penumbra imaging studies that, similar to cerebral tissue viability or perfusion imaging, can be incorporated into the thrombolysis decision-making algorithm.
Source: Journal of Neuro-Ophthalmology - August 25, 2020 Category: Opthalmology Tags: Disease of the Year: Cerebrovascular Disorders Source Type: research

Retinal Vascular Signs and Cerebrovascular Diseases
Conclusions: There is extensive and increasing evidence that a range of retinal vascular signs and disease are closely linked to CeVD, including subclinical and clinical CeVD. New technology including AI-DL will allow further translation to clinical utilization.
Source: Journal of Neuro-Ophthalmology - March 1, 2020 Category: Opthalmology Tags: Disease of the Year: Cerebrovascular Disorders Source Type: research

Obstructive Sleep Apnea in Neuro-Ophthalmology
Conclusions: OSA is associated with many diseases seen in neuro-ophthalmology clinics. More studies are required to assess the real ability of CPAP to reverse pathological changes. Ophthalmologists can screen for undiagnosed OSA in patients presenting with certain eye diseases.
Source: Journal of Neuro-Ophthalmology - August 30, 2019 Category: Opthalmology Tags: State-of-the-Art Review Source Type: research

Risk of Acute Ischemic Stroke in Patients With Monocular Vision Loss of Vascular Etiology
Conclusions: Patients with MVL of vascular etiology such as TMVL, CRAO, or BRAO may have up to 19.5% risk of concurrent ischemic stroke, even when there are no other neurologic deficits. These strokes were detected acutely with brain MRI using DWI but were missed on CT.
Source: Journal of Neuro-Ophthalmology - August 17, 2018 Category: Opthalmology Tags: Original Contribution Source Type: research

Perioperative Retinal Artery Occlusion: Incidence and Risk Factors in Spinal Fusion Surgery From the US National Inpatient Sample 1998–2013
Background: Retinal artery occlusion (RAO) is a rare but devastating complication of spinal fusion surgery. We aimed to determine its incidence and associated risk factors. Methods: Hospitalizations involving spinal fusion surgery were identified by searching the National Inpatient Sample, a database of hospital discharges, from 1998 to 2013. RAO cases were identified using ICD-9-CM codes. Using the STROBE guidelines, postulated risk factors were chosen based on literature review and identified using ICD-9-CM codes. Multivariate logistic models with RAO as outcome, and risk factors, race, age, admission, and surgery t...
Source: Journal of Neuro-Ophthalmology - February 21, 2018 Category: Opthalmology Tags: Original Contribution Source Type: research

New Standards of Care in Ischemic Stroke
Conclusions: Endovascular therapy is now standard of care for eligible patients with anterior large vessel occlusions. Prolonged cardiac monitoring is recommended for patients with cryptogenic stroke. The novel anticoagulants are an alternative to warfarin in patients with AF.
Source: Journal of Neuro-Ophthalmology - August 17, 2017 Category: Opthalmology Tags: State-of-the-Art Review Source Type: research