Acute Central Retinal Artery Occlusion Seen within 24 Hours at a Tertiary Institution
| Autor: | Benjamin I. Meyer, Beau B. Bruce, Alexis M. Flowers, Valérie Biousse, Nancy J. Newman, Wesley Chan |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Retinal Artery Occlusion medicine.medical_treatment Tertiary care Time-to-Treatment Tertiary Care Centers Young Adult Catchment Area Health Fibrinolytic Agents medicine Humans Thrombolytic Therapy Public education Infusions Intravenous Stroke Vision Ocular Aged Retrospective Studies Aged 80 and over business.industry Rehabilitation Tertiary institution Emergency department Thrombolysis Middle Aged medicine.disease Acute vision loss Treatment Outcome Emergency medicine Central retinal artery occlusion Surgery Female Neurology (clinical) Cardiology and Cardiovascular Medicine business Emergency Service Hospital |
| Zdroj: | Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association. 30(9) |
| ISSN: | 1532-8511 |
| Popis: | Objective Acute central retinal artery occlusion (CRAO) is an emergency with poor visual outcome. Intravenous thrombolysis within 4.5 h of vision loss is safe and may improve vision, but is rarely administered because of frequent delays in presentation. We describe a subgroup of CRAO patients presenting within 24 h of vision loss to a tertiary care center affiliated with a comprehensive stroke center. Materials and Methods Retrospective review of 181 consecutive CRAO patients seen at our institution from 2010 to 2020. Results Out of 181 CRAO patients, 62 (34%) presented within 24 h of vision loss and tended to live closer to the hospital. These patients were more likely to be admitted to the hospital and receive comprehensive stroke work-up compared to patients who presented after 24 h of vision loss. Patients presenting after 24 h did not necessarily receive prior appropriate work-up at outside institutions. Conservative treatments for CRAO were administered to 20/181 patients, and only 3 patients received intravenous thrombolysis. Conclusions Patients with CRAO do not present to the emergency department fast enough and diagnosis of CRAO is often delayed. Despite having a protocol in place, only 3/181 patients received IV thrombolysis, emphasizing the difficulty in administering very acute treatments for CRAO. Public education regarding CRAO is necessary to improve presentation times, management, and visual outcomes. Hospitals need to develop accelerated diagnostic pathway protocols for patients with acute vision loss so that CRAO patients may be diagnosed and be considered for potential acute treatments as quickly as possible. |
| Databáze: | OpenAIRE |
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