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Related Experiment Videos

Retinal infarction during sleep and wakefulness.

A Bruno1, J Biller, H P Adams

  • 1Neurology Service, Veterans Administration Medical Center, Albuquerque, N.M. 87108.

Stroke
|October 1, 1990
PubMed
Summary

Retinal infarction, or stroke, is surprisingly common during sleep. Embolism, often from carotid artery disease in older adults, is a frequent cause, suggesting the retina is vulnerable during sleep.

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Area of Science:

  • Ophthalmology
  • Neurology
  • Vascular Medicine

Background:

  • Retinal and brain infarctions during sleep were previously attributed to hypoperfusion and hypotension.
  • The role of embolism as a cause of retinal infarction, particularly during sleep, was unclear.

Purpose of the Study:

  • To investigate the occurrence and causes of retinal infarction during sleep versus wakefulness.
  • To determine the prevalence of embolism and carotid artery disease in patients with retinal infarction.

Main Methods:

  • Studied 24 patients with recent retinal infarction.
  • Performed dilated ophthalmoscopy, carotid artery studies (arteriography or ultrasound), and echocardiography in select patients.
  • Assessed whether infarction occurred during sleep or wakefulness.

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Main Results:

  • Retinal infarction occurred during sleep more often than expected (14/24 patients).
  • Retinal cholesterol emboli were observed in 50% of patients, irrespective of sleep or wakefulness.
  • Carotid artery disease was common in patients with infarction during sleep (7/14) and wakefulness (8/10), especially in those over 50.

Conclusions:

  • Embolism is a significant mechanism for retinal infarction, occurring during both sleep and wakefulness.
  • Extracranial carotid artery disease is a frequent source of retinal emboli in patients over 50.
  • The retina may have increased susceptibility to infarction during sleep.