Evidence map›Paper›PMID 38750601›Full record

ArticleNeurological research and practice2024

Comparison of vascular risk profile and clinical outcomes among patients with central (branch) retinal artery occlusion versus amaurosis fugax.

Norma J Diel, Stefan T Gerner, Thorsten R Doeppner, Martin Juenemann, Toska Maxhuni, Tobias Frühwald, Andre Worm, Omar Alhaj Omar, Lyubomyr Lytvynchuk, Tobias Struffert and 2 more

Abstract read
In one paragraph

Article in Neurological research and practice, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Norma J DielDepartment of Neurology, University Hospital Giessen, Klinikstrasse 33, 35392, Giessen, Germany. norma.diel@neuro.med.uni-giessen.de.ORCID http://orcid.org/0009-0008-7801-7722
Stefan T GernerDepartment of Neurology, University Hospital Giessen, Klinikstrasse 33, 35392, Giessen, Germany.
Thorsten R DoeppnerDepartment of Neurology, University Hospital Giessen, Klinikstrasse 33, 35392, Giessen, Germany.
Martin JuenemannDepartment of Neurology, University Hospital Giessen, Klinikstrasse 33, 35392, Giessen, Germany.
Toska MaxhuniDepartment of Neurology, University Hospital Giessen, Klinikstrasse 33, 35392, Giessen, Germany.
Tobias FrühwaldDepartment of Neurology, University Hospital Giessen, Klinikstrasse 33, 35392, Giessen, Germany.
Andre WormDepartment of Neurology, University Hospital Giessen, Klinikstrasse 33, 35392, Giessen, Germany.
Omar Alhaj OmarDepartment of Neurology, University Hospital Giessen, Klinikstrasse 33, 35392, Giessen, Germany.
Lyubomyr LytvynchukDepartment of Ophthalmology, University Hospital Giessen, Giessen, Germany.
Tobias StruffertDepartment of Neuroradiology, University Hospital Giessen, Giessen, Germany.
Pascal BauerDepartment of Internal Medicine I, Division of Cardiology and Angiology, University Hospital Giessen, Giessen, Germany.
Hagen B HuttnerDepartment of Neurology, University Hospital Giessen, Klinikstrasse 33, 35392, Giessen, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRetinal artery occlusions lead to sudden, painless vision loss, affecting millions globally. Despite their significance, treatment strategies remain unestablished, contrasting with acute ischemic stroke (AIS), where IVT has proven efficacy. Similar to AIS, retinal artery occlusions demand urgent evaluation and treatment, reflecting the principle "time is retina". Even for patients with transient monocular vision loss, also known as amaurosis fugax (AF), pertinent guidelines meanwhile recommend immediate emergency assessment in a specialized facility. However, data on the clinical benefit and comparability with persistent occlusions are missing. This study aimed to compare the results of a comprehensive stroke-workup among patients with persistent retinal artery occlusions (RAO), including both central retinal (CRAO) and branch retinal artery occlusion (BRAO) and those with AF.

methodsConducted at the University Hospital Giessen, Germany, this exploratory cross-sectional study enrolled patients with transient or permanent unilateral vision loss of non-arteritic origin. The primary outcome were differences between the two groups RAO and AF with regard to cardiovascular risk profiles and comorbidities, vascular and pharmacological interventions and clinical neurological and ophthalmological outcomes. Secondary outcome was a sub-group analysis of patients receiving IVT.

resultsOut of 166 patients assessed, 76 with RAO and 40 with AF met the inclusion criteria. Both groups exhibited comparable age, gender distribution, and cardiovascular risk profiles. Notably, RAO patients did not show significantly more severe vascular comorbidities than AF patients. However, AF patients received vascular interventions more frequently. Pharmacological intervention rates were similar across groups. RAO patients had slightly worse neurological outcomes, and IVT did not yield favorable ophthalmological outcomes within any observed patients.

conclusionThe study found similar vascular burden and risk factors in patients with RAO and AF, with implications for clinical workflows. IVT for RAO may only be effective in very early treatment windows. This emphasizes the need for public awareness and collaborative protocols between ophthalmologists and neurologists to improve outcomes.

Indexed as

Amaurosis fugaxCentral retinal artery occlusionIntravenous thrombolysisIschemic strokeTransient ischemic attack

Identifiers

PMID38750601
PMCPMC11097454

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.