TRANSTHORACIC ECHOCARDIOGRAPHY IN YOUNG-PATIENTS WITH ACUTE RETINAL ARTERIAL-OBSTRUCTION

Objective: To report the transthoracic echocardiographic findings in y oung patients presenting with acute retinal arterial obstruction, give n their clinical risk status for cardioembolic disease. Design: Case s eries. Setting: Four North American tertiary hospital centres. Patient s: Eleven patients less than 45 years of age presenting with acute ret inal arterial obstruction who underwent transthoracic echocardiography . Outcome measure: Anticoagulation therapy or cardiac surgery. Results : Echocardiography showed abnormalities in five patients (45%). Five o f the 11 patients were at high risk for cardioembolic disease on the b asis of a history of risk factors or the presence of a cardiac murmur on presentation, or both. Three (60%) of the five had abnormal finding s on echocardiography; all three required anticoagulation therapy or c ardiac surgery. Of the six patients at low risk two (33%) had abnormal echocardiograms; neither required anticoagulation therapy or surgical intervention. Conclusions: All the patients who required anticoagulat ion therapy or cardiac surgery based on the findings on transthoracic echocardiography were deemed to be at high risk for cardioembolic dise ase. This emphasizes the importance of clinical risk stratification in the systemic evaluation of young patients presenting with acute retin al arterial obstruction.