ArticleClinical research in cardiology : official journal of the German Cardiac Society2026
Central retinal artery occlusion: meta-analysis of the risk of new-onset atrial fibrillation and ischemic stroke.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCentral retinal artery occlusion (CRAO) causes irreversible blindness. Atrial fibrillation (AF) is a recognized cause that may not be present at the time of the event.
objectiveWe aimed to assess the relation of CRAO with new-onset AF and ischemic stroke.
methodsWe systematically searched the literature, utilizing the search terms "atrial fibrillation" and "retinal artery occlusion". We used a random effects model to calculate the pooled odds ratio (OR) and 95% confidence intervals (CI) of new-onset AF risk and new-onset ischemic stroke risk in CRAO patients compared to matched controls, as well as the new-onset AF risk compared to ischemic stroke patients. Analysis was performed with Rev-Man 5.4.1.
resultsWe included 1479 patients with CRAO, 9843 matched controls without CRAO and stroke at baseline, and 7058 patients with ischemic stroke for meta-analysis. There were 115 cases of new-onset AF (14%) during a follow-up of 34 months. CRAO was associated with a higher risk for new-onset AF (OR:1.47, 95% CI:1.18-1.83; p = 0.0006) and new ischemic stroke (OR:2.10, 95% CI:1.57-2.82; p < 0.00001) when compared to control patients. The risk of new-onset AF after CRAO was similar to that observed after ischemic stroke (OR:0.80, 95% CI:0.40-1.61; p = 0.54). Follow-up duration and timing of outcome detection varied.
conclusionCRAO is associated with a higher risk of new-onset AF and ischemic stroke. The risk of AF after CRAO is similar to that after an ischemic stroke. Thus, CRAO may be seen as a stroke-equivalent prompting closer follow-up with screening and eventually anticoagulation.
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