Dumitrascu Oana M, English Stephen, Alhayek Nour, Pahl Emily, Nord Charisse, Vanderhye Vanesa, O'Carroll Cumara B, Demaerschalk Bart M
Department of Neurology, Mayo Clinic College of Medicine and Science, Scottsdale, Arizona, USA.
Department of Neurology, Mayo Clinic College of Medicine and Science, Jacksonville, Florida, USA.
Telemed J E Health. 2023 Nov;29(11):1738-1743. doi: 10.1089/tmj.2022.0286. Epub 2023 Mar 13.
Introduction:Central retinal artery occlusion (CRAO) is an under-recognized stroke subtype that may benefit from hyperacute reperfusion therapies. We aimed to evaluate the ability of telestroke activations to provide CRAO diagnosis and thrombolysis.
Methods:This retrospective observational study investigates all encounters conducted for acute visual loss between 2010 and 2021 in our multicentric Mayo Clinic Telestroke Network. Demographics, time from visual loss to telestroke evaluation, ocular examination, diagnostic, and therapeutic recommendations were collected for CRAO subjects.
Results:Out of 9,511, 49 encounters (0.51%) were conducted for an acute ocular complaint. Five patients had possible CRAO, and 4 presented within 4.5 h from symptom onset (range 1.5-5 h). None received thrombolytic therapy. All telestroke physicians recommended ophthalmology consultation.
Conclusion:Current telestroke assessment of acute visual loss is suboptimal and patients eligible for acute reperfusion therapies may not be offered treatment. Teleophthalmologic evaluations and advanced ophthalmic diagnostic tools should complement telestroke systems.
视网膜中央动脉阻塞（CRAO）是一种未被充分认识的中风亚型，可能从超急性再灌注治疗中获益。我们旨在评估远程卒中启动机制用于CRAO诊断和溶栓的能力。
这项回顾性观察性研究调查了2010年至2021年间在我们多中心的梅奥诊所远程卒中网络中因急性视力丧失而进行的所有会诊。收集了CRAO患者的人口统计学信息、从视力丧失到远程卒中评估的时间、眼部检查、诊断和治疗建议。
在9511例中，49例（0.51%）因急性眼部疾病进行了会诊。5例患者可能患有CRAO，4例在症状发作后4.5小时内就诊（范围为1.5 - 5小时）。无人接受溶栓治疗。所有远程卒中医生均建议进行眼科会诊。
目前对急性视力丧失的远程卒中评估并不理想，符合急性再灌注治疗条件的患者可能无法得到治疗。远程眼科评估和先进的眼科诊断工具应补充远程卒中系统。
