Abstract

Objectives: Retinal artery occlusion (RAO) is an acute ophthalmological emergency widely considered to be the equivalent of a cerebral ischemic stroke. Currently, some patients with RAO are initiated in prophylactic antithrombotic treatment and others are not. This study evaluates characteristics of patients with RAO initiated with prophylactic antithrombotic treatment compared to patients whom receive no prophylactic treatment. Method: This preliminary study included all potential patients with RAO identified from the 1st of January 2017 to the 30th of November 2020 in the North Denmark Region. Identification of this patient group was achieved using the International Classification of Diseases (ICD) and data was gathered through each patient’s electronic medical record. Retrospectively the diagnoses of RAO were confirmed. Patients with RAO were grouped by their antithrombotic treatment status and compared in terms of basic characteristics, diagnostic follow-up, time from symptom onset to healthcare contact and time from symptom onset to antithrombotic treatment initiation. Chi squared tests or one-way analysis of variance were used to compare proportions or means between groups. Results: Of the 98 patients with RAO included in this study, 46 were initiated with antithrombotic treatment, 7 received no treatment before or after RAO and 45 were already in antithrombotic treatment before RAO. Most patients were initiated with aspirin (N = 44) and some patients were subsequently prescribed clopidogrel (N = 17) as a mono- or dual antiplatelet therapy. The most prevalent comorbidities were hyperlipidaemia (69.4 %), hypertension (82.7 %) and carotid artery disease (27.6 %). The majority of patients received ultrasound of the carotid arteries (83.7 %) after RAO onset. Patients receiving no treatment were more likely not to have any diagnostic follow-up (n = 3/7)(p = 0.05) and were observed to contact healthcare much later after symptom onset. Conclusion: The majority of patients with RAO received antithrombotic treatment and the standard medication initiated was aspirin. Some patients' antithrombotic treatment was altered to clopidogrel, especially if diagnosed with carotid artery disease. Patients receiving no antithrombotic treatment were observed to have waited a longer period after RAO symptoms before contacting healthcare. These patients were also less likely to receive diagnostic follow-up.

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A master thesis from Aalborg University

Characteristics of patients with retinal artery occlusion initiated with antithrombotic treatment: A pilot study