Central retinal artery occlusion with atrial fibrillation or atrial flutter
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LETTER TO THE EDITOR
Central retinal artery occlusion with atrial fibrillation or atrial flutter Aditya Uppuluri 1 & Sohil Bhagat 2 & Marco A. Zarbin 1 & Neelakshi Bhagat 1 Received: 28 October 2020 / Revised: 28 October 2020 / Accepted: 6 November 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Dear Editor, In this present study, the 2002–2014 National Inpatient Sample (NIS) Database was used to perform a retrospective cross-sectional case-control study to identify comorbidities associated with a diagnosis of central retinal artery obstruction (CRAO) in patients with atrial fibrillation and atrial flutter (AFF) over 65 years of age [1, 2] While previous studies have established that AFF increases the risk of CRAO [3, 4], this is the first study to utilize a national dataset to identify additional risk factors in this at-risk population. The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) was used to identify cases and controls, systemic conditions, and ocular findings. The case group (739 patients) comprised patients over 65 years of age who were admitted to the hospital for CRAO (ICD-9 code 362.31) and a concurrent diagnosis of AFF. The age- and sex-matched control group (3689 patients) included randomly selected patients over the age of 65 years with AFF and without retinal artery occlusion. Statistical analysis was performed using IBM SPSS 23 and R package version 3.4.3. CHADS-VASC scores were calculated as per the guidelines put forth by Lip and colleagues [5]. In the 2002–2014 NIS Database, there were 739 (weighted) cases and 3689 (weighted) controls. The cases and controls were age- and gender-matched. The average ages of cases and controls were 79.2 years and 79.4 years (p = 0.452), respectively. Men comprised 55.0% of controls and 55.6% of cases (p = 0.759). Table 1 presents the results of our chi-square analysis and independent samples t testing. There was no significant difference in the CHADS-VASC scores of the controls and cases
* Neelakshi Bhagat [email protected] 1
Department of Ophthalmology and Visual Sciences, Rutgers New Jersey Medical School, 90 Bergen Street Doctor Office Center, Suite 6100, Newark, NJ 07103, USA
2
A.T. Still University, 800 West Jefferson Street, Kirksville, MO 63501, USA
(3.90 vs. 4.00; p = 0.055). Carotid stenosis, hyperlipidemia, hypertension, history of stroke (hemorrhagic and ischemic), and glaucoma were more prevalent in patients with CRAO than in those without CRAO (p < 0.05). Cases had a shorter duration of hospitalization compared to controls (3.60 days vs. 5.90 days; p < 0.001). Cases had a higher average cost per day ($9407) than controls ($7989) (p < 0001). With regard to acute complications, 5.7% of patients with CRAO developed nonhemorrhagic vaso-occlusive cerebral stroke during hospitalization, compared to 1.0% of controls (p < 0.001). Controls had a higher rate of in-hospital myocardial infarctions, 2.6%, than cases, 1.2% (p = 0.024). In the control group, 171 (4.6%) patients died durin
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