Atrial fibrillation as a novel risk factor for retinal stroke: A protocol for a population-based retrospective cohort study.

Central retinal artery occlusion (CRAO; retinal stroke or eye stroke) is an under-recognized, disabling form of acute ischemic stroke which causes severe visual loss in one eye. The classical risk factor for CRAO is ipsilateral carotid stenosis; however, nearly half of patients with CRAO do not have high-grade carotid stenosis, suggesting that other cardiovascular risk factors may exist for CRAO. Specifically, prior studies have suggested that cardioembolism, driven by underlying atrial fibrillation, may predispose patients to CRAO. We describe the design of an observational, population-based study in this protocol. We evaluate two specific objectives: 1) To determine if atrial fibrillation is an independent risk factor for CRAO after adjusting for medical and cardiovascular risk; 2) To determine if use of oral anticoagulation can modify the risk of CRAO for patients with atrial fibrillation. This protocol lays out our strategy for cohort definition, case and control definition, comorbidity ascertainment, and statistical methods.

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Copyright: © 2023 Lusk et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Déclaration de conflit d'intérêts

“I have read the journal’s policy and the authors of the manuscript have the following interests: J.B. Lusk is supported by the American Heart Association. Dr Biousse is supported by the National Institutes of Health National Eye Institute core grant P30-EY06360 (Department of Ophthalmology, Emory University School of Medicine) and by a departmental grant from the Research to Prevent Blindness (New York, NY) and is a consultant for GenSight Biologics and Neurophoenix. Dr Schrag reports compensation from the REVISION trial for data and safety monitoring services; compensation from Raymond James for consultant services; grants from the National Institutes of Health; and compensation from Labaton Sucharow for consultant services. Dr Poli reports grants from the Helena Laboratories Corporation, Bristol Myers Squibb, Boehringer Ingelheim, and the Daiichi Sankyo Company; compensation from Alexion Pharmaceuticals, Inc, Portola Pharmaceuticals LLC, Werfen USA LLC, and AstraZeneca for consultant services; and compensation from Boehringer Ingelheim, Bristol Myers Squibb, the Daiichi Sankyo Company, and Bayer Healthcare for other services. Dr Piccini reports compensation from Biotronik, Inc, Philips, Medtronic, Boston Scientific Corporation, ResMed Foundation, Ablacon, LivaNova USA, Inc, AltaThera Pharmaceuticals LLC, AbbVie Biotherapeutics, Abbott Laboratories, ElectroPhysiology Frontiers, Itamar Medical, Inc, ARCA biopharma, Pfizer, Bristol Myers Squibb, Sanofi US Services, Inc, and Milestone Scientific, for consultant services; employment by the Duke University; and grants from the American Heart Association and iRhythm Technologies. Dr O’Brien reports compensation from Boehringer Ingelheim for consultant services and employment by the Duke University. B. Mac Grory is supported by a grant from the National Institutes of Health (K23HL161426). The other authors report no conflicts. This does not alter our adherence to PLOS ONE policies on sharing data and materials.”