Abstract

DO.01.14

Transthoracic echocardiography and carotid doppler ultrasound for detection of cardiac and carotid artery disease in patients with acute central retinal artery obstruction (CRAO) and central retinal vein occlusion (CRVO)

Klatt C., Purtskhvanidze K., Hasselbach H., Treumer F., Roider J.
Klinik für Augenheilkunde, Universitätsklinikum Schleswig-Holstein, Campus Kiel

Objective: We reviewed the medical records of patients with acute central retinal artery obstruction (CRAO) and central retinal vein occlusion (CRVO) and evaluated the risk factors as well as the importance of transthoracic echocardiography (TTE) and carotid Doppler ultrasound in determining causes of cardiac and carotid artery origin in CRAO and CRVO.
Methods: A retrospective case study comprised 80 patients presenting retinal circulatory disorder (CRAO 38, CRVO 42) who underwent systemic evaluation and isovolemic hemodilution between January 01, 2002 and December 31, 2005. TTE was accomplished in 48 patients (60%) (CRAO 31, CRVO 17) and carotid Doppler ultrasound was accomplished in 55 patients (68,5%) (CRAO 34, CRVO 21).
Results: Among these patients, abnormal cardiac findings were detected in 19 patients (61,3%) in CRAO and 4 patients (23,5%) in CRVO (p=0,01). About one half of these cases are counted in both groups among valvular heart diseases, followed by hypertrophy of the heart. Only in one case of CRAO a thrombus was detected in the atrium. Abnormal carotid findings were detected in 19 patients in CRAO (44,1%) and in 2 patients in CRVO (9,5%) (p=0,04). Most frequently plaque within the carotid was documented (CRAO 26,5% vs. CRVO 9,5%) followed by stenosis (CRAO 17,6% vs. CRVO 4,75%) and und calcification (CRAO 5,9% vs. CRVO 0%).
Conclusions: In patients with CRAO, TTE and carotid Doppler ultrasound play an important role in contemporary pinpointing the origins of retinal emboli and planning treatment strategies. In CRVO these examinations do not seem to be as urgent as in CRAO. Nevertheless they are not dispensable but it appears to be allowed to delegate them into the ambulant care.

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