Cath lab: Retinal Emboli after Cardiac Cath (Adult)

Clinical significance of retinal emboli during diagnostic and therapeutic cardiac catheterization in patient with coronary artery disease

Javad Kojuri , Morteza Mehdizadeh , Hamed Rostami and Danial Shahidian

BMC Cardiovascular Disorders 2011, 11:5doi:10.1186/1471-2261-11-5

Published:	21 January 2011

Abstract (provisional)

Background

Cardiac catheterization may cause retinal embolization, a risk factor for cerebrovascular emboli and stroke. We describe the incidence of clinically silent and apparent retinal emboli following diagnostic and interventional coronary catheterization and associated risk factors.

Methods

Three hundred selected patients attending a tertiary referral center for diagnostic and therapeutic cardiac catheterization were studied. Direct retinal examination and examination of the visual field and acuity were done before and after catheterization by a retinal specialist.

Results

There was 5 case of retinal embolus before catheterization, and 19 patients (incidence 6.3%) developed new retinal arteriolar emboli after catheterization. Only 1 patient developed clinically apparent changes in vision. Two conventional risk factors (age and hypertension) were significantly associated with new retinal emboli. The risk of retinal emboli was also significantly associated with operator expertise.

Conclusions

Retinal embolism was found after coronary catheterization in 6.3% of our patients. This finding indicates that the retinal, and possibly the cerebral circulation, may be compromised more frequently than is clinically apparent as a complication of coronary catheterization. Age and hypertension are independent predictors of retinal embolism (clinical trial registrationNCT01157338)