on August 14, 2008
Published online before print August 14, 2008, doi: 10.1161/STROKEAHA.108.516591
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Submitted on February 4, 2008
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. * To whom correspondence should be addressed. 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.
Accepted on March 3, 2008
Acute Retinal Arteriolar Emboli After Cardiac Catheterization
Andreas J. Kreis MD;
Key words: catheter • coronary • coronary artery disease • embolus • retina • stroke