TY - JOUR
T1 - Telemedicine for Acute Monocular Visual Loss
T2 - A Retrospective Large Telestroke Network Experience
AU - Dumitrascu, Oana M.
AU - English, Stephen
AU - Alhayek, Nour
AU - Pahl, Emily
AU - Nord, Charisse
AU - Vanderhye, Vanesa
AU - O’Carroll, Cumara B.
AU - Demaerschalk, Bart M.
N1 - Publisher Copyright:
© 2023 Mary Ann Liebert Inc.. All rights reserved.
PY - 2023/11/1
Y1 - 2023/11/1
N2 - Introduction: Central retinal artery occlusion (CRAO) is an under-recognized stroke subtype that may benefit from hyperacute reperfusion therapies. We aimed to evaluate the ability of telestroke activations to provide CRAO diagnosis and thrombolysis. Methods: This retrospective observational study investigates all encounters conducted for acute visual loss between 2010 and 2021 in our multicentric Mayo Clinic Telestroke Network. Demographics, time from visual loss to telestroke evaluation, ocular examination, diagnostic, and therapeutic recommendations were collected for CRAO subjects. Results: Out of 9,511, 49 encounters (0.51%) were conducted for an acute ocular complaint. Five patients had possible CRAO, and 4 presented within 4.5 h from symptom onset (range 1.5–5 h). None received thrombolytic therapy. All telestroke physicians recommended ophthalmology consultation. Conclusion: Current telestroke assessment of acute visual loss is suboptimal and patients eligible for acute reperfusion therapies may not be offered treatment. Teleophthalmologic evaluations and advanced ophthalmic diagnostic tools should complement telestroke systems.
AB - Introduction: Central retinal artery occlusion (CRAO) is an under-recognized stroke subtype that may benefit from hyperacute reperfusion therapies. We aimed to evaluate the ability of telestroke activations to provide CRAO diagnosis and thrombolysis. Methods: This retrospective observational study investigates all encounters conducted for acute visual loss between 2010 and 2021 in our multicentric Mayo Clinic Telestroke Network. Demographics, time from visual loss to telestroke evaluation, ocular examination, diagnostic, and therapeutic recommendations were collected for CRAO subjects. Results: Out of 9,511, 49 encounters (0.51%) were conducted for an acute ocular complaint. Five patients had possible CRAO, and 4 presented within 4.5 h from symptom onset (range 1.5–5 h). None received thrombolytic therapy. All telestroke physicians recommended ophthalmology consultation. Conclusion: Current telestroke assessment of acute visual loss is suboptimal and patients eligible for acute reperfusion therapies may not be offered treatment. Teleophthalmologic evaluations and advanced ophthalmic diagnostic tools should complement telestroke systems.
KW - retinal ischemia
KW - stroke
KW - teleophthalmology
KW - telestroke
UR - http://www.scopus.com/inward/record.url?scp=85163160811&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85163160811&partnerID=8YFLogxK
U2 - 10.1089/tmj.2022.0286
DO - 10.1089/tmj.2022.0286
M3 - Article
C2 - 36912816
AN - SCOPUS:85163160811
SN - 1530-5627
VL - 29
SP - 1738
EP - 1743
JO - Telemedicine and e-Health
JF - Telemedicine and e-Health
IS - 11
ER -