Acute Retinal Arteriolar Emboli After Cardiac Catheterization

• Published in: Stroke (1970) Vol. 39; no. 11; pp. 3086 - 3087
• Main Authors: KREIS, Andreas J, NGUYEN, Thanh, ROGERS, Sophie, JIE JIN WANG, HARPER, C. Alex, CLARK, David J, FAROUQUE, H. M. Omar, WONG, Tien Y
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01.11.2008
• Subjects: Aged; Aged, 80 and over; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Cardiac Catheterization - adverse effects; Embolism - etiology; Embolism - pathology; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care; Humans; Intensive care medicine; Male; Medical sciences; Middle Aged; Neurology; Retinal Artery - pathology; Retinal Artery Occlusion - etiology; Risk Factors; Vascular diseases and vascular malformations of the nervous system; coronary artery disease; Stroke; Nervous system diseases; catheter; coronary; Catheterization; Cardiovascular disease; Retina; Coronary heart disease; Cerebral disorder; Vascular disease; Central nervous system disease; embolus; Cerebrovascular disease
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/STROKEAHA.108.516591

There are concerns that cardiac catheterization may cause retinal embolization, a risk marker for cerebrovascular emboli and stroke. We describe the incidence of acute retinal embolism after cardiac catheterization. One hundred unselected patients attending a tertiary referral center for diagnostic cardiac catheterization were recruited. Digital retinal photography (optic disc and macular fields) was performed precatheterization and within 3 hours postcatheterization. New retinal emboli were identified by a senior researcher and confirmed by a retinal specialist. There was one case of retinal embolus precatheterization. Two patients (incidence 2.02%; 95% CI, 0.25 to 7.11) developed new retinal arteriolar emboli after catheterization. No patient developed clinically apparent visual or neurological changes. The risk of acute retinal embolism immediately after cardiac catheterization is 2%. This finding indicates that the retinal, and possibly the cerebral circulation, may be compromised more frequently than is clinically apparent as a complication of cardiac catheterization.