Melanahalli Shreyas, Tran Tommy, Ng Clement, Agrawal Devendra K
Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, California 91766 USA.
Cardiol Cardiovasc Med. 2025;9(4):234-247. Epub 2025 Jul 7.
Retinal artery occlusions, encompassing central retinal artery occlusion and branch retinal artery occlusion, are acute vascular events that can result in significant and often irreversible vision loss. These ocular emergencies are closely associated with systemic vascular risk factors, including hypertension, diabetes mellitus, advanced age, and cardiovascular comorbidities. Atrial fibrillation (AFib), the most common sustained cardiac arrhythmia, has emerged as a notable contributor to the risk of retinal artery occlusions. The prevalence of AFib is rising, particularly among older adults, paralleling the age-dependent increase in retinal artery occlusion incidence. Recent studies indicate a significant association between AFib and retinal artery occlusions, with AFib conferring an elevated risk for both retinal and cerebral ischemic events. Notably, Patients with retinal artery occlusion exhibit a heightened risk of subsequent AFib, stroke, and thromboembolic complications. The pathophysiological interplay involves embolic phenomena originating from cardiac or carotid sources, with AFib facilitating thrombus formation and embolization to the retinal circulation. Diagnostic advances, including prolonged cardiac monitoring and optical coherence tomography, have improved detection of both AFib and retinal ischemic changes. Despite the lack of a universally accepted treatment for retinal artery occlusions, early interventions such as thrombolysis and hyperbaric oxygen therapy may improve visual outcomes if administered promptly. This manuscript underscores the importance of comprehensive cardiovascular evaluation in patients with retinal artery occlusion, particularly for AFib, to optimize risk stratification, guide management, and reduce the likelihood of recurrent vascular events. Enhanced awareness and interdisciplinary collaboration are critical to improving prognosis and preventing further morbidity in this high-risk population.
视网膜动脉阻塞，包括视网膜中央动脉阻塞和视网膜分支动脉阻塞，是急性血管事件，可导致严重且往往不可逆的视力丧失。这些眼部急症与全身血管危险因素密切相关，包括高血压、糖尿病、高龄和心血管合并症。心房颤动（房颤）是最常见的持续性心律失常，已成为视网膜动脉阻塞风险的一个显著因素。房颤的患病率正在上升，尤其是在老年人中，这与视网膜动脉阻塞发病率随年龄增长而增加的情况相平行。最近的研究表明房颤与视网膜动脉阻塞之间存在显著关联，房颤会增加视网膜和脑缺血事件的风险。值得注意的是，视网膜动脉阻塞患者随后发生房颤、中风和血栓栓塞并发症的风险更高。病理生理相互作用涉及源自心脏或颈动脉的栓塞现象，房颤促进血栓形成并栓塞至视网膜循环。诊断进展，包括延长心脏监测和光学相干断层扫描，提高了对房颤和视网膜缺血变化的检测。尽管对于视网膜动脉阻塞缺乏普遍接受的治疗方法，但早期干预，如溶栓和高压氧治疗，如果及时进行，可能会改善视力结果。本文强调了对视网膜动脉阻塞患者，特别是房颤患者进行全面心血管评估的重要性，以优化风险分层、指导管理并降低血管事件复发的可能性。提高认识和跨学科合作对于改善这一高危人群的预后和预防进一步发病至关重要。
