title: Co-occurrence of acute retinal artery occlusion and acute ischemic stroke: diffusion-weighted magnetic resonance imaging study.
abstract: OBJECTIVE
  To evaluate the co-occurrence of acute ischemic stroke and acute retinal artery occlusion (RAO).
  
  
  METHODS
  Retrospective observational case series.
  
  
  METHODS
  We included 33 consecutive patients with acute RAO who underwent diffusion-weighted magnetic resonance imaging within 7 days of the onset of visual symptoms. The causes of RAO were classified according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria, which are based on clinical features and the results of etiological evaluations for atherosclerosis, cardioembolism and other prothrombotic conditions. We evaluated the prevalence of accompanying acute ischemic stroke in subjects with acute RAO and examined the relationships with etiological parameters.
  
  
  RESULTS
  Acute ischemic stroke was detected in 8 (24.2%) subjects with RAO. Among these subjects, 3 (37.5%) patients did not exhibit any neurologic symptoms or signs. Most of the infarction patterns were small, multiple and scattered. All of the subjects with RAO who were positive for lesions on diffusion-weighted imaging had identifiable causes, whereas only 36% of the subjects who were negative for lesions had identifiable etiologies (P = .003). Carotid stenosis or cardioembolic sources were found more commonly in cases of central retinal artery occlusion (CRAO; 7/18, 38.9%) than in cases of branch retinal artery occlusion (BRAO; 1/15 6.7%, P = .046).
  
  
  CONCLUSIONS
  Acute cerebral infarctions frequently accompany RAO. We recommend diffusion-weighted imaging for patients with RAO because the presence of lesions on diffusion-weighted imaging is accompanied by a significantly increased probability of identifying the cause.
authors: Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea.
authors: Junwon
authors: J
authors: Lee
authors: Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.
authors: Seung Woo
authors: SW
authors: Kim
authors: Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea.
authors: Sung Chul
authors: SC
authors: Lee
authors: Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea.
authors: Oh Woong
authors: OW
authors: Kwon
authors: Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.
authors: Young Dae
authors: YD
authors: Kim
authors: Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea. Electronic address: shbyeon@yuhs.ac.kr.
authors: Suk Ho
authors: SH
authors: Byeon
mesh_terms: D000208:Acute Disease; D000368:Aged; D002544:Cerebral Infarction / Q000150:complications* / Q000175:diagnosis; D038524:Diffusion Magnetic Resonance Imaging; D017548:Echocardiography, Transesophageal; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D015356:Retinal Artery Occlusion / Q000150:complications* / Q000175:diagnosis; D012189:Retrospective Studies; D014792:Visual Acuity; D055815:Young Adult