Callizo Josep, Feltgen Nicolas, Ammermann Antje, Ganser Janina, Bemme Sebastian, Bertelmann Thomas, Pfeiffer Sebastian, Duvinage Andre, Gröschel Klaus, Hoerauf Hans, Wachter Rolf
Clinic for Ophthalmology, University of Göttingen, Göttingen, Germany.
Institute for Clinical Research GmbH, Georg-August University, Goettingen, Germany.
PLoS One. 2017 Aug 3;12(8):e0181766. doi: 10.1371/journal.pone.0181766. eCollection 2017.
Patients with retinal vascular occlusion disease have an increased risk for ischemic stroke and share some risk factors with cerebrovascular disease. The purpose of this study was to analyze the prevalence of atrial fibrillation (AF) in subjects with retinal vascular occlusive disease and anterior ischemic optic neuropathy and to compare these data to an ischemic stroke group.
Prospective, observational single-center trial. Subjects with retinal artery occlusion (RAO), retinal vein occlusion (RVO) and anterior ischemic optic neuropathy (AION) were included. Patients with ischemic stroke (IS) from a previous observational trial were used as control. Investigation included 7-day Holter ECG, echocardiography, duplex ultrasonography of the carotid arteries, and 24-hour blood pressure monitoring. Further vascular risk factors were documented.
During the 1-year study period, 101 patients were recruited. The control group with ischemic stroke consisted of 272 subjects. At inclusion, the prevalence of AF was 12% (RAO), 10.2% (RVO), 11.1% (NAION) and 15.8% (IS). The final prevalence after Holter ECG rose to 16% (RAO), 18.4% (RVO), 14.8% (NAION) and 26.5% (IS). No significant difference was measured between groups.
We detected a similar prevalence of AF in all groups. RVO patients tended to exhibit a higher AF detection rate and lower number needed to screen than RAO and NAION. The detection of AF rose considerably via Holter ECG. As a consequence, we recommend prolonged ECG monitoring in patients with acute ophthalmic vascular diseases.
视网膜血管阻塞性疾病患者发生缺血性中风的风险增加，且与脑血管疾病有一些共同的危险因素。本研究的目的是分析视网膜血管阻塞性疾病和前部缺血性视神经病变患者心房颤动（AF）的患病率，并将这些数据与缺血性中风组进行比较。
前瞻性、观察性单中心试验。纳入视网膜动脉阻塞（RAO）、视网膜静脉阻塞（RVO）和前部缺血性视神经病变（AION）患者。将先前一项观察性试验中的缺血性中风（IS）患者作为对照。调查包括7天动态心电图、超声心动图、颈动脉双功超声检查和24小时血压监测。记录其他血管危险因素。
在1年的研究期间，共招募了101例患者。缺血性中风对照组由272名受试者组成。纳入时，AF的患病率分别为12%（RAO）、10.2%（RVO）、11.1%（非动脉炎性前部缺血性视神经病变[NAION]）和15.8%（IS）。动态心电图检查后的最终患病率分别升至16%（RAO）、18.4%（RVO）、14.8%（NAION）和26.5%（IS）。各组之间未测得显著差异。
我们在所有组中检测到相似的AF患病率。RVO患者的AF检出率往往较高，筛查所需人数比RAO和NAION患者少。通过动态心电图检查，AF的检出率大幅上升。因此，我们建议对急性眼科血管疾病患者进行延长心电图监测。
