title: Amaurosis fugax - delay between symptoms and surgery by specialty.
abstract: OBJECTIVE
  To describe the time course of management of patients with amaurosis fugax and analyze differences in management by different specialties.
  
  
  METHODS
  Patients diagnosed with amaurosis fugax and subjected to carotid ultrasound in 2004-2010 at the Sahlgrenska University Hospital, Gothenburg, Sweden (n=302) were included in this retrospective cohort study, and data were collected from medical records.
  
  
  RESULTS
  The prevalence of significant carotid stenosis was 18.9%, and 14.2% were subjected to carotid endarterectomy. A trend of longer delay for surgery was noted for patients first consulting a general practitioner (P=0.069) as compared to hospital-based specialties. For 46.3% of the patients, an ophthalmologist was their first medical contact. No significant difference in time interval to endarterectomy was seen between ophthalmologists and neurologists/internists. Only 31.8% of the patients with significant carotid stenosis had carotid endarterectomy within 2 weeks from the debut of symptoms, and this proportion was smaller for patients residing outside the Gothenburg city area (P=0.038).
  
  
  CONCLUSIONS
  Initially consulting an ophthalmologist does not delay the time to ultrasound or carotid endarterectomy. The overall time from symptoms to surgery is longer than recommended for a majority of the patients, especially for patients from rural areas and for patients initially consulting a general practitioner.
authors.affiliation: Department of Ophthalmology, Skaraborg Hospital, Skövde.
authors.forename: Pia
authors.initials: P
authors.lastname: Kvickström
authors.affiliation: Department of Clinical Neuroscience/Ophthalmology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg; Department of Ophthalmology, Sahlgrenska University Hospital, Mölndal.
authors.forename: Bertil
authors.initials: B
authors.lastname: Lindblom
authors.affiliation: Department of Molecular and Clinical Medicine, The Sahlgrenska Academy at University of Gothenburg; Department of Clinical Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Göran
authors.initials: G
authors.lastname: Bergström
authors.affiliation: Department of Clinical Neuroscience/Ophthalmology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg; Department of Ophthalmology, Sahlgrenska University Hospital, Mölndal.
authors.forename: Madeleine
authors.initials: M
authors.lastname: Zetterberg
keywords: amaurosis fugax; carotid endarterectomy; carotid stenosis; carotid ultrasound; transient ischemic attack; transient monocular visual loss