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(Stroke. 2008;39:3086.)
© 2008 American Heart Association, Inc.

Research Letters

Acute Retinal Arteriolar Emboli After Cardiac Catheterization

Andreas J. Kreis, MD; Thanh Nguyen, MBBS; Sophie Rogers, MEpi; Jie Jin Wang, MMed, PhD; C. Alex Harper, MD; David J. Clark, MBBS; H.M. Omar Farouque, MBBS, PhD Tien Y. Wong, MD, PhD

From the Centre for Eye Research Australia (A.J.K., T.N., S.R., J.J.W., C.A.H., T.Y.W.), Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, Australia; the Centre for Vision Research (J.J.W.), Westmead Millennium Institute, University of Sydney, Sydney, Australia; the Department of Cardiology (D.J.C., H.M.O.F.), Austin Hospital and University of Melbourne, Melbourne, Australia; and the Singapore Eye Research Institute (T.Y.W.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

Correspondence to Tien Y. Wong, MD, PhD, Centre for Eye Research Australia, University of Melbourne, 32 Gisborne Street, Victoria 3002, Australia. E-mail twong{at}unimelb.edu.au

Background and Purpose— There are concerns that cardiac catheterization may cause retinal embolization, a risk marker for cerebrovascular emboli and stroke. We describe the incidence of acute retinal embolism after cardiac catheterization.

Methods— One hundred unselected patients attending a tertiary referral center for diagnostic cardiac catheterization were recruited. Digital retinal photography (optic disc and macular fields) was performed precatheterization and within 3 hours postcatheterization. New retinal emboli were identified by a senior researcher and confirmed by a retinal specialist.

Results— There was one case of retinal embolus precatheterization. Two patients (incidence 2.02%; 95% CI, 0.25 to 7.11) developed new retinal arteriolar emboli after catheterization. No patient developed clinically apparent visual or neurological changes.

Conclusions— The risk of acute retinal embolism immediately after cardiac catheterization is 2%. This finding indicates that the retinal, and possibly the cerebral circulation, may be compromised more frequently than is clinically apparent as a complication of cardiac catheterization.

Key Words: catheter • coronary • coronary artery disease • embolus • retina • stroke