MICROEMBOLI ARE NOT A PREREQUISITE IN RETINAL ARTERY OCCLUSIVE DISEASES

Purpose Retinal artery occlusion (RAO) is caused by arterio-arterial o r cardiovascular emboli in about 50% of all cases, but the role of non -embolic causes remains unclear. Subjects and methods We studied 27 pa tients with amaurosis fugax (AFX), branch retinal artery occlusion (BR AO), central retinal artery occlusion (CRAO) and anterior ischaemic op tic neuropathy (AION). Patients underwent an evaluation of cerebrovasc ular and cardiovascular risk factors, measurement of haemorheological parameters, and Doppler/duplex sonography including ultrasound detecti on of cerebral microembolic signals and echocardiography. Results Fort y-one per cent of the patients had internal carotid atherosclerosis bu t only one patient had microembolic signals, probably due to a cardiac thrombus. Vascular risk factors, especially hypertension, were presen t in 82% of the patients correlating with abnormal haemorheological pa rameters such as increased thrombocyte reactivity. Conclusions Our res ults indicate that altered haemorheological parameters, especially inc reased thrombocyte reactivity and vascular risk factors such as arteri al hypertension, are non-embolic causes of vascular disease in a signi ficant number of patients with RAG. This should guide diagnostic and t herapeutic considerations concerning RAO in cases without proven embol ic sources.