Abstract TP256: DWI Positive Cerebral Lesion is the Risk of Ischemic Stroke in Retinal Ischemic Patients

Abstract

Background: Retinal ischemia might be mainly caused by carotid stenosis and warning sign for ischemic stroke. Retinal ischemia is rare condition, therefore it is uncertain what lead to ischemic stroke in retinal-ischemic-patient. Methods: We retrospectively identified 128 patients who diagnosed retinal ischemia at 3 hospitals using each hospital stroke database collected from April 1st 2004 to Jun 30th 2016. We extracted data as patient sex, age, comorbidities and checked medical record for detecting recurrent of ischemic stroke and retinal ischemia. Logistic regression analysis was performed to analyze the effect of various factors on the recurrent of ischemic stroke. Results: The mean age of the patients at admission was 69 years old, and 93 patients (73%) was men. Seventy nine patients were diagnosed amaurosis fugax and 49 were retinal embolism. More than one visual defect attack had seen in 25 patients. One hundred twenty three patients were done cerebral MRI and DWI positive ischemic lesion was revealed in 12patients.Carotid stenosis were detected in 38 patients, patent foramen ovale were 40 patients, atrial fibrillation were 8 patients, complicated aortic plaque were 36 patients, and cancer were 25 patients. Mean follow-up period was 645 days and 6 patients had ischemic stroke, 4 had retinal ischemia and 18 underwent surgical intervention (carotid endarterectomy 12, carotid stenting 4, extracranial to intracranial bypass 2). Multivariable analysis found that the prevalence of ischemic stroke was significantly increased in DWI positive (odds ratio 10.9, confidence interval 1.7-69.6), under treatment cancer (10.0, 1.2-85.0), more than one visual attack (2.8, 1.1-7.3). Conclusion: DWI positive ischemic lesion on cerebral MRI was risk factor for ischemic stroke in retinal ischemic patients. We should consider to do MRI on retinal ischemic patients.