Ankle-Brachial Index as a Predictor of Acute Ischemic Cerebrovascular Event After Central Retinal Artery Occlusion

BACKGROUND Identifying patients at higher risk of acute ischemic cerebrovascular events (AICE) following central retinal artery occlusion (CRAO) is crucial for secondary prevention of stroke. This study aimed to investigate whether a low ankle-brachial index value is associated with an increased risk of AICE after CRAO. MATERIAL AND METHODS We prospectively analyzed patients who were admitted to our hospital because of CRAO between February 2019 and March 2023 and whose ankle-brachial index was no greater than 1.40. We explored the potential association between the index and risk of AICE (defined as ischemic stroke or transient ischemic attack) within 1 year after occlusion. Patients were classified into 2 groups according to whether their index was low (≤0.90) or normal (0.91-1.40). RESULTS Of the 335 patients in the final analysis, 110 (32.8%) had an ankle-brachial index of ≤0.90 and 89 (26.6%) experienced AICE during 1-year follow-up. In univariable analysis, patients with a low index had a significantly higher AICE incidence than those with a normal index (36.4% vs 21.8%, P<0.01). Multivariable logistic regression analysis, adjusting for variables associated with low index, identified low index as an independent predictor of AICE after CRAO (OR 1.864, 95% CI 1.095-3.174, P=0.022). CONCLUSIONS Low values of the ankle-brachial index may independently predict higher risk of AICE after CRAO. This index may serve as a non-invasive screening tool for patients with CRAO who require intensified secondary stroke prevention.