Clinical significance of retinal emboli during diagnostic and therapeutic cardiac catheterization in patients with coronary artery disease

Kojuri, Javad; Mehdizadeh, Morteza; Rostami, Hamed; Shahidian, Danial

doi:10.1186/1471-2261-11-5

Cited by 11 publications

(21 citation statements)

References 18 publications

(23 reference statements)

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“…In another comprehensive, prospective study by Kojuri et al in 2011 looking at retinal and visual changes after diagnostic and therapeutic cardiac catheterisation procedures in 300 patients, 6.3% (n=19) of patients were found to have retinal emboli 17 to 96 hours following cardiac catheterisation. 5 This study included patients with diabetes which accounted for one third of their study population but only used the direct ophthalmoscope examination and unfortunately did not report on the breakdown of the exact subtypes of retinal lesions that were diagnosed as embolic in nature.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have shown the risk of retinal embolisation to be as high as 55% to 100% after coronary bypass surgery, 1 2 about 1.25% to 13.2% after carotid stenting 3 4 and about 6.3% after cardiac catheterisation. 5 For patients with severe symptomatic aortic stenosis (AS), valvular replacement has been increasingly performed via a femoral catheter technique called transcatheter aortic valve implantation (TAVI). 6 7 While it is a significantly less invasive procedure than traditional surgical valve replacement, current studies suggest that TAVI carries a moderately high cerebrovascular accident rate of up to 5%.…”

Section: Introductionmentioning

confidence: 99%

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Retinal embolic events: frequency and impact following transcatheter aortic valve implantation (TAVI) for aortic stenosis

et al. 2017

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ObjectivesTranscatheter aortic valve implantation (TAVI) is an established treatment for patients with severe symptomatic aortic stenosis. It has a cerebrovascular accident rate of about 5% but the effect on retinal embolic events has not been previously reported. This study investigated the occurrence of retinal emboli following TAVI.Methods and analysisIn this prospective observational study, 20 patients underwent full ophthalmic examination to assess retinal embolic events prior to TAVI and at 48 hours and 1 month post-TAVI.ResultsAt 48 hours post-TAVI, one patient had a new cotton wool spot in the right eye. At 1 month, another two patients had new retinal emboli events in at least one eye and a fourth patient developed retinal splinter haemorrhages in the right eye.ConclusionRetinal embolic events and new retinal abnormalities following TAVI occurred in 15% and 20% of our cohort, respectively, without any associated retinal damage or significant visual problems. Retinal evaluation may be a useful surrogate test for cerebral embolisation in future studies assessing the utility of new valve prostheses and embolic protection devices

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Retinal embolic events: frequency and impact following transcatheter aortic valve implantation (TAVI) for aortic stenosis

et al. 2017

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“…None of them had vision loss. Kojuri et al 8 reported on 300 patients, with 6% having retinal emboli. Only one of the 300 experienced symptoms.…”

Section: Discussionmentioning

confidence: 99%

Preservation of retinal structure and function after cilioretinal artery occlusion: a case report

Brown¹

2016

IMCRJ

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Cilioretinal artery occlusion is a cause of sudden, often catastrophic loss of central vision. There are no established effective treatments. Recently, a patient presented 24 hours after a cilioretinal artery occlusion, following a cardiac catheterization prior to which her blood thinners had been discontinued. Lacking an effective way to address the severe retinal ischemic oxidative stress, she was offered, under compassionate use, a multivitamin complex designed to address retinal ischemia and oxidative stress. Significant components of this product are L-methylfolate and n-acetyl cysteine. The patient experienced a rapid unexpected improvement in vision and preservation of retinal structure, suggesting that marked improvement in retinal artery occlusions outcomes may be possible as late as 24 hours postocclusion. This is the third reported case of cilioretinal artery occlusion associated with cardiac catheterization.

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“…The incidence of new retinal emboli post-PCI was 6.33 % (19 out of 300 subjects, all asymptomatic) in one landmark study [4]. The same study also found two conventional risk factors (age and hypertension) and operator expertise were strongly associated with new retinal emboli.…”

Section: Discussionmentioning

confidence: 97%

Why can’t I see after my heart is fixed: a case series of ocular complications after cardiac intervention

et al. 2016

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BackgroundThe purpose of this study was to report case series of retinal artery occlusion (RAO) as one of the significant complication post cardiac intervention.Case presentationWe are reporting one case of branch RAO and one case of central RAO after percutaneous coronary intervention (PCI). In case 1, a 74-year-old gentleman with pre-existing diabetes mellitus and hypertension was electively admitted for PCI for coronary artery disease (CAD) in our centre (UKMMC). Few hours after the procedure, patient complained of sudden blurring of vision in the right eye. He was found to have branch retinal artery occlusion. In case 2, a 49-year-old gentleman presented with ST segment elevation myocardial infarction (STEMI) and had an emergency PCI performed 2 h upon admission. He noticed sudden dropped of vision in his right eye immediately after the procedure. He was diagnosed to have central retinal artery occlusion.ConclusionsIn conclusion, retinal artery occlusion is a possible complication post PCI. Patients need to be informed especially in high risk cases.

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Clinical significance of retinal emboli during diagnostic and therapeutic cardiac catheterization in patients with coronary artery disease

Cited by 11 publications

References 18 publications

Retinal embolic events: frequency and impact following transcatheter aortic valve implantation (TAVI) for aortic stenosis

Retinal embolic events: frequency and impact following transcatheter aortic valve implantation (TAVI) for aortic stenosis

Preservation of retinal structure and function after cilioretinal artery occlusion: a case report

Why can’t I see after my heart is fixed: a case series of ocular complications after cardiac intervention

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