Risk and Risk Periods for Stroke and Acute Myocardial Infarction in Patients with Central Retinal Artery Occlusion

Sang Jun Park, Nam Kyong Choi, Bo Ram Yang, Kyu Hyung Park, Joongyub Lee, Sun Young Jung, Se Joon Woo

Research output: Contribution to journalArticlepeer-review

118 Scopus citations

Abstract

Purpose To investigate the risk of stroke and acute myocardial infarction (AMI) in patients with incident central retinal artery occlusion (CRAO). Design A self-controlled case series (SCCS) study. Participants Patients with incident CRAO from the entire Korean population of 48 million individuals. Methods We used the Korean national claim database (2007-2011) for analyses. After identifying patients with incident CRAO, the relative incidence rate ratios (IRRs) for stroke and AMI in risk periods were measured in these patients using a SCCS method. Main Outcome Measures The IRRs of stroke and AMI by risk periods. Results Of 1655 patients with incident CRAO in 2009-2010, 165 had stroke/AMI (ischemic stroke in 139, hemorrhagic stroke in 13, and AMI in 15) in the observation period spanning 365 days before and after the occurrence of CRAO. The IRR of stroke/AMI 1 to 30 days after CRAO occurrence significantly increased (14.0; 95% confidence interval [CI], 8.90-22.00); the IRR peaked during the 1 to 7 days after CRAO occurrence (44.51; 95% CI, 27.07-73.20), and the increased risk was present for the first 30 days. The IRR of stroke/AMI also significantly increased 1 to 30 days (6.82; 95% CI, 4.01-11.60) and 31 to 90 days (2.86; 95% CI, 1.66-4.93) before CRAO occurrence. Subanalysis for only ischemic stroke showed similar, magnified IRRs in the risk periods compared with all events. The IRRs were not significantly different between sexes or age groups (<65 vs. ≤65 years). Conclusions Patients with incident CRAO are at increased risk of ischemic stroke just after CRAO occurrence, and the risk is particularly increased during the first week immediately after the CRAO occurrence. The results suggest that patients with incident CRAO require immediate neurologic evaluation and preventive treatment to reduce mortality and morbidity.

Original languageEnglish
Pages (from-to)2336-2343.e2
JournalOphthalmology
Volume122
Issue number11
DOIs
StatePublished - Nov 2015

Bibliographical note

Publisher Copyright:
© 2015 American Academy of Ophthalmology.

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