1115 Undertreatment of vascular risk factors in patients presenting with ischaemic ocular events: results from 395 patients in a tertiary centre

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Abstract

Introduction

Ocular events are considered lower risk than other transient ischaemic attacks (TIA). We aimed to determine recurrence risk, prevalence and management of vascular risk factors.

Setting

University College Hospital London daily TIA-clinic, main referral centre for North-Central London. Consecutive records for all patients with transient/permanent ischaemic visual loss reviewed, January 2014-September 2016.

Results

Of 395 patients, mean age 64 years (SD=15.1), 261 (66%) had transient and 134 (34%) permanent events. 51.1% had hypertension, 34.4% hypercholesterolaemia, 14.7% diabetes, 10.9% ocular events, 10.1% ischaemic heart disease (IHD), 7.1% atrial fibrillation (AF), 6.3% TIA, 5.1% stroke, and 12.4% were smokers. Median risk factors was 1 (range 1–6), but 88 (22.3%) had ≥3. Permanent visual loss was more common in patients with previous IHD (p<0.001), TIA (p<0.001), ocular events (p<0.001), diabetes (p=0.032), hypertension (p<0.001) and smokers (p=0.077). 90 day recurrence was 10.1%, higher (14.8%) in patients with ≥3 risk factors (HR=1.67, 95%CI=[0.89–3.09], p=0.120). Secondary prevention was better in patients with past TIA than those with ocular events; 60% vs 45% received antiplatelets and 92% vs 51% statins. Only 16 (51.6%) with known AF were anticoagulated, despite all having CHADSVASC≥1.

Conclusion

One-fifth of patients with ocular events had ≥3 risk factors; these had higher recurrences. Only half of patients with previous ocular events were on antiplatelets/statins. These patients should be investigated and treated as aggressively as other TIA/strokes.

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