title: Transient retinopathy in acute aortic dissection.
abstract: OBJECTIVE
  To explore the occurrence of transient retinopathy and its prognostic importance in patients with acute aortic dissection (AAD).
  
  
  METHODS
  Prospective, observational study.
  
  
  METHODS
  Sixty-four patients with Stanford type B AAD were treated with conservative medical therapy.
  
  
  METHODS
  Retinopathy findings, such as cotton-wool spots and hemorrhage, were examined. Fundus photography was performed on hospital days 9 to 14 and after 2 or 3 months. The association between the appearance of retinopathy and the subsequent cardio-cerebrovascular events was investigated.
  
  
  METHODS
  The primary outcomes included the incidence of retinopathy and subsequent adverse cardio-cerebrovascular events.
  
  
  RESULTS
  Retinopathy was detected in 55% (35 of 64) of patients (cotton-wool spots alone, n = 31; dot hemorrhage alone, n = 1; and both, n = 3). These findings disappeared in all 12 patients who underwent follow-up fundus examinations. In the multivariate analysis, a history of hypertension and higher peak C-reactive protein level were independently associated with retinopathy. At a median follow-up of 911 days, adverse cardio-cerebrovascular events were reported in 11 patients, of whom those with retinopathy experienced adverse events significantly more frequently than those without retinopathy (P = 0.045).
  
  
  CONCLUSIONS
  Retinopathy occurred frequently in patients with AAD. This retinopathy was associated with a history of hypertension and higher peak C-reactive protein levels and was an important predictive factor for adverse cardio-cerebrovascular outcomes.
authors.affiliation: Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan. Electronic address: araon@omiya.jichi.ac.jp.
authors.forename: Kenshiro
authors.initials: K
authors.lastname: Arao
authors.affiliation: Division of Cardiovascular Medicine, Nikko Medical Center, Dokkyo Medical University, Tochigi, Japan.
authors.forename: Asuka
authors.initials: A
authors.lastname: Kuribara
authors.affiliation: Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Jinnouchi
authors.affiliation: Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Mitsunari
authors.initials: M
authors.lastname: Matsumoto
authors.affiliation: Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Fujiwara
authors.affiliation: Division of Ophthalmology, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Nozomi
authors.initials: N
authors.lastname: Kinoshita
authors.affiliation: Division of Ophthalmology, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Kakehashi
authors.affiliation: Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Junya
authors.initials: J
authors.lastname: Ako
authors.affiliation: Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Momomura
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D017545:Aortic Aneurysm, Thoracic / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D001794:Blood Pressure; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D010781:Photography; D011379:Prognosis; D011446:Prospective Studies; D012164:Retinal Diseases / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology
chemical_list: D002097:C-Reactive Protein