Self-reported health status of patients with acute retinal ischemia and stroke related hemianopia.

BACKGROUND

We aimed to assess impairments on health-related quality of life, and mental health resulting from Retinal artery occlusion (RAO) with monocular visual field loss and posterior circulation ischemic stroke (PCIS) with full or partial hemianopia using patient-reported outcome measures (PROMs).

METHODS

In a prospective study, consecutive patients with acute RAO on fundoscopy and PCIS on imaging were recruited during their surveillance on a stroke unit over a period of 15 months. Baseline characteristics were determined from medical records and interviews. Health-related quality of life (PROM Information System 10-Question-Short-Form, PROMIS-10), and mental health symptoms (Patient-Health-Questionnaire-4, PHQ-4) were assessed 3 and 12 months after admission postally and via phone.

RESULTS

Ffity-seven patients with RAO and 19 with isolated full or partial hemianopia determined by the NIHSS (median = 2; IQR:0/2) according to PCIS were included. Characteristics of cardiovascular risk factors, and functional status pre-stroke were comparable between the groups. At 3 months, mean ± standard deviation -scores of PROMIS physical and mental health were 47.1 ± 8.8 and 46.7 ± 8.8 for patients with RAO, and 43.4 ± 9.8 and 43.2 ± 6.2 for PCIS. Compared to 50 ± 10 in the general population, scores after RAO ( = 0.04;  = 0.02) and PCIS ( = 0.01;  < 0.001) were lower in both domains after 3 months. Concerning PCIS, scores in the mental health domain remained decreased at 12 months ( = 0.04). On the PHQ-4, 25% of patients with RAO, and 62% with PCIS scored indicative for anxious and/or depressive syndromes at 3 months.

CONCLUSIONS

RAO led only to partial and to less persistent mental impairments than PCIS. This suggests that a different approach involving complex visual and neuropsychological treatment over a longer period of time needs to be considered for post-stroke care of PCIS.

TRIAL REGISTRATION INFORMATION

The trial was submitted at http://www.clinicaltrials.gov, under NCT03795948.