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Mortality and stroke after amaurosis fugax
Journal of Neurology, Neurosurgery, and Psychiatry
|September 1, 1985
Summary
Patients experiencing amaurosis fugax (transient vision loss) have reduced life expectancy and higher risks of stroke and ischemic heart disease compared to the general population. Early detection of carotid artery issues is crucial for stroke risk assessment.
Area of Science:
- Neurology
- Cardiology
- Ophthalmology
- Vascular Medicine
Background:
- Amaurosis fugax, a transient monocular vision loss, is often a symptom of underlying cerebrovascular disease.
- Understanding the long-term prognosis and associated risks in patients with amaurosis fugax is critical for clinical management.
Purpose of the Study:
- To retrospectively evaluate the long-term mortality and stroke incidence in patients treated medically for amaurosis fugax.
- To compare the outcomes of amaurosis fugax patients with age- and sex-matched general populations and stroke cohorts.
- To identify risk factors, such as carotid artery status, associated with adverse events in this patient group.
Main Methods:
- Retrospective study of 110 patients presenting with amaurosis fugax and receiving medical treatment.
- Long-term follow-up ranging from 6 to 19 years (median 8 years).
- Comparison of mortality and stroke rates with matched general population data and published stroke project results.
- Assessment of the impact of carotid artery findings (occlusion or narrowing) on subsequent stroke risk.
Main Results:
- Patients with amaurosis fugax exhibited reduced life expectancy compared to the general population.
- Ischemic heart disease was the leading cause of death, occurring at a significantly higher rate (p < 0.01).
- The incidence of stroke was elevated (p < 0.01) compared to the Oxfordshire Community Stroke Project.
- Patients with occluded or narrowed proximal internal carotid arteries had a significantly higher risk of subsequent stroke (p < 0.01).
Conclusions:
- Amaurosis fugax is associated with increased mortality, primarily from ischemic heart disease, and a higher risk of stroke.
- While stroke incidence may be lower than in transient ischemic attack cohorts, amaurosis fugax patients face significant vascular risks.
- Carotid artery stenosis or occlusion in amaurosis fugax patients is a strong predictor of future stroke events, necessitating vigilant monitoring and management.