PRESS-NEWS.org - Press Release Distribution
PRESS RELEASES DISTRIBUTION

Stroke affecting the eye requires immediate treatment, can signal future vascular events

American Heart Association scientific statement

2021-03-08
(Press-News.org) DALLAS, March 8, 2021 - While most people think of strokes affecting the brain, they can also affect the eye. Central retinal artery occlusion (CRAO) is a rare form of acute ischemic stroke that occurs when blood flow is blocked to the main artery of the eye. It typically causes painless, immediate vision loss in the impacted eye, with fewer than 20% of people regaining functional vision in that eye.

Today, the American Heart Association published a new scientific statement, "Management of Central Retinal Artery Occlusion," in Stroke, an American Heart Association journal. The American Association of Neurological Surgeons/Congress of Neurological Surgeons Cerebrovascular Section affirms the educational benefit of the scientific statement, and it has been endorsed by the North American Neuro-Ophthalmology Society, the American Academy of Ophthalmology Quality of Care Secretariat and the American Academy of Optometry.

"Central retinal artery occlusion is a cardiovascular problem disguised as an eye problem. It is less common than stroke affecting the brain but is a critical sign of ill health and requires immediate medical attention," said Chair of the statement writing committee Brian C. Mac Grory, M.B.B.Ch., B.A.O., M.R.C.P., an assistant professor of neurology and staff neurologist at the Duke Comprehensive Stroke Center at Duke University School of Medicine in Durham, North Carolina. "Unfortunately, a CRAO is a warning sign of other vascular issues, so ongoing follow-up is critical to prevent a future stroke or heart attack."

In a comprehensive review of the world literature, committee members from the specialties of neurology, ophthalmology, cardiology, interventional neuroradiology, neurosurgery and vitreoretinal surgery summarized the state of the science in this condition. They found indications that this type of stroke can be caused by problems with carotid arteries, the blood vessels in the neck. However, there is also evidence CRAOs could be caused by problems with the heart, such as atrial fibrillation, which is the most common irregular heart rhythm. The risk of having a CRAO increases with age and in the presence of cardiovascular risk factors such as hypertension, hyperlipidemia, Type 2 diabetes, smoking and obesity.

The new scientific statement notes the lack of large clinical trials on CRAOs leads to uncertainty within the medical community of exactly what causes them or the best way to treat them. As a result, there is wide variability in diagnosis and treatment methods. Most concerning, according to Mac Grory, is that many practitioners may not recognize CRAO as a form of stroke resulting in patients receiving delayed testing and treatment, often in the outpatient clinic instead of the emergency department.

"We know acute CRAO is a medical emergency requiring early recognition and triage to emergency medical treatment," Mac Grory said. "There is a narrow time window for effective treatment of CRAO and a high rate of serious related illness. So, if a person is diagnosed in a doctor's office or other outpatient clinic, they should be immediately sent to a hospital emergency department for further evaluation and treatment."

Current literature suggests that treatment with intravenous tissue plasminogen activator (tPA), a "clot buster" that is also used to treat brain strokes, may be effective. But tPA must be administered within 4.5 hours of the first sign of symptoms to be most effective and safe.

The writing committee also noted that emerging treatments, such as hyperbaric oxygen and intra-arterial alteplase, show promise but require further study. Other potential treatments that require further research and evaluation include novel thrombolytics to break up clots and novel neuroprotectants (substances capable of preserving brain function and structure) for use in tandem with other therapies to restore blood flow in the blocked artery.

Because of the potential for future strokes or even heart attacks, patients should undergo urgent screening and treatment of vascular risk factors. The writing committee notes that the complexities of diagnosing and treating CRAOs require a team of specialists working together. Secondary prevention (including monitoring for complications) must be a collaborative effort between neurologists, ophthalmologists, cardiologists and primary care clinicians. Risk factor modification includes lifestyle and pharmacological interventions.

INFORMATION:

The Writing Committee of the new scientific statement included members of the American Heart Association's Stroke Council; the Council on Arteriosclerosis, Thrombosis and Vascular Biology; the Council on Hypertension; and the Council on Peripheral Vascular Disease.

Additional writing committee members are Matthew Schrag, M.D., Ph.D., Vice-Chair; Valérie Biousse, M.D.; Karen L. Furie, M.D., M.P.H., FAHA; Marie Gerhard-Herman, M.D.; Patrick J. Lavin, M.B.B.Ch., B.A.O., M.R.C.P.I.; Lucia Sobrin, M.D., M.P.H.; Stavropoula I. Tjoumakaris, M.D.; Cornelia Weyand, M.D., Ph.D.; and Shadi Yaghi, M.D., FAHA. Author disclosures are available on the manuscript.

The work of the Writing Committee was supported exclusively by the American Heart Association without commercial support, and members of the Writing Committee volunteered their time.

Additional Resources:

Multimedia is available on the right column of the release link:
https://newsroom.heart.org/news/stroke-affecting-the-eye-requires-immediate-treatment-can-signal-future-vascular-events?preview=9a0bfec0859d258eacaf5fb146569f77
After March 8, view the manuscript online. Follow AHA/ASA news on Twitter @HeartNews
Follow news from Stroke, the ASA/AHA journal @StrokeAHA_ASA Statements and conclusions of studies published in the American Heart Association's scientific journals are solely those of the study authors and do not necessarily reflect the Association's policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. The Association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and biotech companies, device manufacturers and health insurance providers are available here, and the Association's overall financial information is available here.

About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. We are dedicated to ensuring equitable health in all communities. Through collaboration with numerous organizations, and powered by millions of volunteers, we fund innovative research, advocate for the public's health and share lifesaving resources. The Dallas-based organization has been a leading source of health information for nearly a century. Connect with us on heart.org, Facebook, Twitter or by calling 1-800-AHA-USA1.



ELSE PRESS RELEASES FROM THIS DATE:

Immune cells in cerebrospinal fluid predict response to immunotherapy

Immune cells in cerebrospinal fluid predict response to immunotherapy
2021-03-08
The analysis of immune cells infiltrating cerebrospinal fluid enables the characterization of the tumor microenvironment in brain metastases. Findings reported today in Nature Communications* confirm that these cells recapitulate the characteristics of those detected in brain metastases, and could act as novel and non-invasive biomarkers to predict patient responsiveness to immune-based therapies. Results from a study led by Joan Seoane, Director of Preclinical and Translational Research co-program at VHIO and ICREA Professor, show that immune cells accessing cerebrospinal fluid faithfully recapitulate the characteristics of cells identified in brain metastasis, and could therefore constitute novel ...

Virtual avatar coaching with community context for adult-child dyads

Virtual avatar coaching with community context for adult-child dyads
2021-03-08
Philadelphia, March 8, 2021 - Virtual reality avatar-based coaching shows promise to increase access to and extend the reach of nutrition education programs to children at risk for obesity, according to a new study in the Journal of Nutrition Education and Behavior, published by Elsevier. Researchers introduced 15 adult-child dyads to a virtual avatar-based coaching program that incorporated age-specific information on growth; physical, social, and emotional development; healthy lifestyles; common nutrition concerns; and interview questions around eating behaviors and food resources and counseling. "We developed a virtual reality avatar computer program ...

Globalization of cancer clinical trials linked to lower enrollment of Black patients

2021-03-08
For the drug approval process in the United States, investigators have been expanding clinical trials to sites outside the country. However, a new study indicates that this trend may be widening racial disparities in patient enrollment in cancer clinical trials. The study is published by Wiley early online in END ...

Drug to treat hypoactive sexual desire disorder in women of 'very limited use'

2021-03-08
An independent analysis of the medical trials which formed the final basis of approval by the US Food and Drug Administration (FDA) strongly suggests the drug bremelanotide has very limited effectiveness as a treatment for hypoactive sexual desire disorder (HSDD) in women, and that trial participants preferred a placebo. The analysis, published today in the peer-reviewed Journal of Sex Research, also highlights issues with the validity of HSDD as a diagnosis. The condition was removed from the American Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013. Professor Glen Spielmans, of Metropolitan State University, USA, examined data from bremelanotide's FDA New Drug Application, ...

Investigating youth suicides among children involved with the welfare system

2021-03-08
Suicide is the second leading cause of death among youth aged 5 to 21 years in the United States. Between 2010 and 2019, suicide rates among this group increased 40%. Youth involved in the child welfare system experience an even greater risk of suicidal behavior, yet research on this vulnerable population is minimal. To better understand and prevent suicide in this at-risk group, researchers at Nationwide Children's Hospital conducted the first study to compare characteristics and health service utilization patterns of youth suicide decedents (those ...

Study suggests wearing a face mask during intense exercise is safe for healthy people

2021-03-08
Wearing a protective face mask has only a modest effect on the ability of healthy people to do vigorous exercise, according to a study published today (Monday) in the European Respiratory Journal [1]. Researchers carried out detailed testing on breathing, heart activity and exercise performance in a group of 12 people while they were using an exercise bike with and without a mask. Although they found differences in some measurements between wearing a mask and not wearing a mask, they say that none of their results indicate any risk to health. This suggests that masks could be worn safely during intense exercise, for example to reduce COVID-19 transmission between ...

One size doesn't fit all when it comes to products for preventing HIV from anal sex

2021-03-06
The initial insights from the study, aptly named DESIRE (Developing and Evaluating Short-acting Innovations for Rectal Use), are being reported on March 6 in a Science Spotlight session at the virtual meeting of the Conference on Retroviruses and Opportunistic Infections (CROI), March 6-10. The presentation will be available for registered participants and media to view throughout the meeting. Conducted by the National Institutes of Health (NIH)-funded Microbicide Trials Network (MTN), DESIRE focused on potential delivery methods for rectal microbicides - topical products being developed and tested to reduce ...

"Magic sand" might help us understand the physics of granular matter

2021-03-06
Tokyo, Japan - Researchers from Tokyo Metropolitan University have studied the properties of mixtures of silicone-coated "magic sand", a popular kid's toy, and normal sand. Silicone-coated sand particles were found to interact with each other only, and not with other sand particles. The team discovered that adding silicone-coated sand beyond a certain threshold leads to an abrupt change in clustering and rigidity, a simple, useful way to potentially tune the flow of granular materials for industry. Sand is a fascinating material. It can flow and be poured like a liquid, ...

WRAIR, Duke scientists find evidence of monoclonal antibodies activity against malaria

2021-03-05
Scientists at Walter Reed Army Institute of Research, in a collaboration with Duke University, have confirmed that monoclonal antibodies can be an effective tool in the global fight against malaria. The study, led by Dr. Sheetij Dutta, chief of the Structural Vaccinology Laboratory at WRAIR, showed that mAbs such as CIS43 were most effective in a culture-based assay that measured malaria parasites' ability to infect a human liver cell, while another mAb 317 showed the best activity in a mouse infection model. Dutta added "difference in assay outcomes for mAbs could reflect distinct sites on the circumsporozoite protein that can be exploited for developing improved vaccines." The ...

Physics camp has proven benefits for high school girls

Physics camp has proven benefits for high school girls
2021-03-05
HOUSTON - (March 5, 2021) - Even a small effort up front can boost the abilities and confidence of girls as they anticipate taking challenging science courses. A long-running summer program at Rice University and elsewhere that trains high school girls in basic physics concepts has proven successful in helping them thrive when they take on full courses the next year. When leaders of Rice's two-week day camp looked at similar programs beyond Houston, they found participants scored 3% better in high school physics than their counterparts who did not have the equivalent summer experience. "That doesn't seem like a lot, but it's really hard to move the needle on student outcomes, so 3% is significant," said Carolyn Nichol, an assistant ...

LAST 30 PRESS RELEASES:

Heart failure in space: scientists calculate potential health threats facing future space tourists in microgravity

Experts offer guidance on talking with children about racism at pediatrician's office

Drugs for HIV and AIDS trialed as brain tumor treatment for first time

Breakthrough in nanoscale force measurement opens doors to unprecedented biological insights

Scientists discover new behavior of membranes that could lead to unprecedented separations

When inflicting pain on others pays off T

The Lancet: Managing gestational diabetes much earlier in pregnancy can prevent complications and improve long-term health outcomes, experts say

New study finds dinosaur fossils did not inspire the mythological griffin

NASA astronaut Woody Hoburg to deliver keynote address at ISSRDC focused on developing a space workforce

Study: Fatigue-management training improved sleep, safety, well-being for Seattle police

Guiding humanity beyond the moon: OHIO’s Nate Szewczyk and students coauthor papers published in “Nature” journals that revolutionize human space biology

Grant supports research to identify barriers to health care for Black women

Scientists at uOttawa develop innovative method to validate quantum photonics circuits performance

New report on community-centered approach to providing vaccine education and resources to persons experiencing homelessness during COVID-19

Government updates race and ethnicity data collection standards: implications and insights

Dr. Vivek S. Kavadi named CEO of the American Society for Radiation Oncology (ASTRO)

Dietary sucrose determines activity of lithium on gene expression and lifespan in drosophila melanogaster

Assessment of CEA, CA-125, and CA19-9 as adjuncts in non-small cell lung cancer management

Iron meteorites hint that our infant solar system was more doughnut than dartboard

Anti-trust regulators should consider their options carefully when start-ups are acquired, new study suggests

Family conditions may have more of an impact on upward social mobility than gender inequality

People with higher weight, and those who have high-quality experiences with higher-weight people, report less weight bias, per social psychology study of US adults

In two separate clinical studies, combined immunotherapy approach enhances cancer patient response

Airborne mapping reveals roles for biogenic sources and temperature in air pollution emissions in Los Angeles

Old bombs reveal new insights: Plants store more carbon, but for a shorter time frame, than we thought

The time it takes a person to decide can predict their preference

Hurricane changed ‘rules of the game’ in monkey society

Researchers widely observe yet seldom publish about same-sex sexual behavior in primates and other mammals - often because it is perceived to be rare

Wild chimpanzees seek out medicinal plants to treat illness and injuries

New catalyst unveils the hidden power of water for green hydrogen generation

[Press-News.org] Stroke affecting the eye requires immediate treatment, can signal future vascular events
American Heart Association scientific statement