Amaurosis fugax: risk factors and prevalence of significant carotid stenosis

The purpose of this study was to describe clinical characteristics and prevalence of carotid stenosis in patients with amaurosis fugax (AF).

Patients diagnosed with AF and subjected to carotid ultrasound in 2004-2010 in Sahlgrenska University Hospital, Gothenburg (n=302), were included, and data were retrospectively collected from medical records.

The prevalence of significant carotid stenosis was 18.9%, and 14.2% of the subjects were subjected to carotid endarterectomy. Significant associations with risk of having ≥70% stenosis were male sex (adjusted odds ratio [aOR]: 2.62; 95% confidence interval [CI]: 1.26-5.46), current smoking (aOR: 6.26; 95% CI: 2.62-14.93), diabetes (aOR: 3.68; 95% CI: 1.37-9.90) and previous vasculitis (aOR: 10.78; 95% CI: 1.36-85.5). A majority of the patients (81.4%) was seen by an ophthalmologist prior to the first ultrasound. Only 1.7% of the patients exhibited retinal artery emboli at examination.

The prevalence of carotid stenosis among patients with AF is higher than has previously been demonstrated in stroke patients. An association with previously reported vascular risk factors and with vasculitis is seen in this patient group. Ocular findings are scarce.