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In Vivo Vascular Injury Readouts in Mouse Retina to Promote Reproducibility

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Risk and Predictors of Fellow-Eye Involvement Following Unilateral Retinal Artery Occlusion.

Jawad Muayad¹, Sam Karimaghaei², Muhammad Z Chauhan¹

¹Bernice and Harvey Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA.

Ophthalmology. Retina

|July 9, 2026

Summary

Fellow-eye retinal artery occlusion (RAO) affects about 1 in 25 central RAO and 1 in 31 branch RAO patients within 5 years. Risk factors and event patterns suggest different causes, highlighting the need for close monitoring after initial RAO.

Keywords:

BRAO CRAO Fellow eye Retinal artery occlusion

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Published on: November 12, 2020

Area of Science:

Ophthalmology
Neurology
Vascular Medicine

Background:

Retinal artery occlusion (RAO) is a serious vascular event affecting vision.
Understanding the risk of fellow-eye involvement after unilateral RAO is crucial for patient management.
Predictors and temporal patterns of fellow-eye RAO require further elucidation.

Purpose of the Study:

To determine the 5-year event probability of fellow-eye RAO after unilateral central RAO (CRAO) or branch RAO (BRAO).
To analyze the temporal pattern of fellow-eye RAO development.
To identify baseline predictors associated with fellow-eye RAO.

Main Methods:

Retrospective cohort study of 10,085 CRAO and 9,574 BRAO patients from the TriNetX US Collaborative Network (2015-2025).
Kaplan-Meier analysis estimated 5-year event probability.
Baseline characteristics were compared between patients with and without fellow-eye RAO using statistical tests with Bonferroni correction.

Main Results:

Fellow-eye RAO occurred in 4.06% of CRAO patients and 3.22% of BRAO patients within 5 years.
Index RAO type predicted fellow-eye RAO subtype (CRAO to CRAO, BRAO to BRAO).
Significant predictors for CRAO included cerebral infarction, carotid stenosis, hypertension, diabetes, diabetic retinopathy, and sleep apnea; for BRAO, predictors included retinal vasculitis, ocular hypertension, and diabetes-related factors.

Conclusions:

Fellow-eye RAO incidence is approximately 1 in 25 for CRAO and 1 in 31 for BRAO within 5 years.
Concordance of RAO subtype and distinct risk profiles suggest different pathophysiologies.
Findings support patient counseling and emphasize close follow-up in the initial months post-RAO.