Retinal Artery Occlusion Significantly Increases Risk of Ischemic Stroke: Meta-Analysis Shows
Thailand: A systematic review and meta-analysis published in Scientific Reports has revealed a significant association between retinal artery occlusion (RAO) and ischemic cerebrovascular disease (CVD). The findings emphasize the importance of stroke risk assessment in patients presenting with RAO.
RAO, a condition characterized by sudden blockage of blood flow to the retina, has long been recognized as a potential warning sign for systemic vascular events. Thananop Pothikamjorn and colleagues from the Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand, aimed to quantify the incidence of ischemic CVD—including ischemic stroke, silent stroke, transient ischemic attack (TIA), and amaurosis fugax (AF)—in patients with RAO, as well as to identify key risk factors.
The study synthesized data from 46 studies encompassing 101,952 patients. It led to the following notable findings:
- The overall incidence of ischemic cerebrovascular disease (CVD) in patients with retinal artery occlusion (RAO) was 13.6%.
- Central retinal artery occlusion (CRAO) had an incidence of 14.4%, while branch retinal artery occlusion (BRAO) showed a higher incidence of 22.2%.
- Patients with CRAO had a 1.6-fold greater risk of ischemic CVD compared to those with BRAO (OR 1.59).
- Individuals with any form of RAO had a 2.75-fold increased likelihood of developing ischemic cerebrovascular events compared to those without RAO.
- Significant risk factors for ischemic CVD in RAO patients included atrial fibrillation (OR 1.32), chronic heart failure (OR 1.51), valvular heart disease (OR 1.60), dyslipidemia (OR 1.30), and smoking (OR 1.16).
- The findings underscore the importance of managing modifiable cardiovascular risk factors to reduce the risk of ischemic events in RAO patients.
According to the authors, “The presence of RAO should trigger prompt evaluation for underlying cardiovascular disease and vigilant monitoring for cerebrovascular complications.” They emphasized that early recognition and aggressive management of these risk factors could substantially reduce the likelihood of subsequent strokes in this patient population.
The study adhered to PRISMA guidelines. Its comprehensive analysis provides robust evidence that RAO is not merely an ocular event but a marker of systemic vascular vulnerability. Clinicians are encouraged to incorporate RAO screening into broader cardiovascular risk assessments and to counsel patients regarding lifestyle modifications and medical management to prevent future cerebrovascular events.
"The findings from this meta-analysis highlight RAO as a significant predictor of ischemic cerebrovascular disease. By identifying high-risk patients and implementing preventive strategies, healthcare providers can potentially improve long-term neurological outcomes and reduce the burden of stroke in patients with retinal vascular disorders," the authors concluded.
Reference:
Pothikamjorn, T., Charnnarong, C., Susantitaphong, P., & Jariyakosol, S. (2025). Incidence and risk factors associated with ischemic cerebrovascular disease in patients with retinal artery occlusion: A systematic review and meta-analysis. Scientific Reports, 15(1), 1-12. https://doi.org/10.1038/s41598-025-18419-7
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