Management and outcome of cholesterol embolus identified in a diabetic retinopathy screening program

K. Whitehouse, P.M. Dodson

Research output: Contribution to journalMeeting abstract

Abstract

Purpose. We examined the incidence, management, and outcomes of patients known to be at high cardiovascular risk, and to assess whether specialist referral to an ophthalmic medical clinic is worthwhile.
Methods. Patients in the East Birmingham area with cholesterolembolus who were identified on digital diabetic retinopathy screening over a 3-year period were referred to a specialist ophthalmic medicine clinic within Heart of England NHS Trust for management and investigation.
Results. A total of 33 patients were referred for clinical management.(male:female = 22:11, mean age 72 years). A total of 28 patients were known to be receiving medication: 14 anti hypertensive therapy(42%), 19 aspirin (59%), and 21 statin (64%). A total of 18 patients had known cardiovascular disease, 10 of whom had received carotid stenting or coronary artery bypass surgery. Ten patients diagnosed with embolus required and consented to carotid Doppler studies. Six patients were confirmed with significant carotid stenosis and 2 (6%)of these patients required carotid endarterectomy surgery. Overall, 4patients died, a mortality rate of 12% over 3 years.
Conclusions. Annual diabetic retinopathy screening provide sopportunistic identification of asymptomatic cholesterol emboli and provides an opportunity for review of medical management in the high-risk patient group with appropriate identification and referral for carotid stenosis surgery. A total of 11 patients were identified with sub optimal cardiovascular risk management: e.g., statin use.
Original languageEnglish
Pages (from-to)350-351
Number of pages2
JournalEuropean Journal of Ophthalmology
Volume21
Issue number3
DOIs
Publication statusPublished - 15 Apr 2011
Event21st Meeting of the European Association for the Study of Diabetes Eye Complications Study Group (EASDec) - Gdansk, Poland
Duration: 13 May 201115 May 2011

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Diabetic Retinopathy
Embolism
Cholesterol
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Carotid Stenosis
Referral and Consultation
Carotid Endarterectomy
Risk Management
Carotid Arteries
Coronary Artery Bypass
England
Antihypertensive Agents
Aspirin
Cardiovascular Diseases
Medicine
Mortality
Incidence

Bibliographical note

Abstracts of the 21st Meeting of the European Association for the Study of Diabetes Eye Complications Study Group (EASDEc)

Cite this

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title = "Management and outcome of cholesterol embolus identified in a diabetic retinopathy screening program",
abstract = "Purpose. We examined the incidence, management, and outcomes of patients known to be at high cardiovascular risk, and to assess whether specialist referral to an ophthalmic medical clinic is worthwhile. Methods. Patients in the East Birmingham area with cholesterolembolus who were identified on digital diabetic retinopathy screening over a 3-year period were referred to a specialist ophthalmic medicine clinic within Heart of England NHS Trust for management and investigation. Results. A total of 33 patients were referred for clinical management.(male:female = 22:11, mean age 72 years). A total of 28 patients were known to be receiving medication: 14 anti hypertensive therapy(42{\%}), 19 aspirin (59{\%}), and 21 statin (64{\%}). A total of 18 patients had known cardiovascular disease, 10 of whom had received carotid stenting or coronary artery bypass surgery. Ten patients diagnosed with embolus required and consented to carotid Doppler studies. Six patients were confirmed with significant carotid stenosis and 2 (6{\%})of these patients required carotid endarterectomy surgery. Overall, 4patients died, a mortality rate of 12{\%} over 3 years. Conclusions. Annual diabetic retinopathy screening provide sopportunistic identification of asymptomatic cholesterol emboli and provides an opportunity for review of medical management in the high-risk patient group with appropriate identification and referral for carotid stenosis surgery. A total of 11 patients were identified with sub optimal cardiovascular risk management: e.g., statin use.",
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Management and outcome of cholesterol embolus identified in a diabetic retinopathy screening program. / Whitehouse, K.; Dodson, P.M.

In: European Journal of Ophthalmology, Vol. 21, No. 3, 15.04.2011, p. 350-351.

Research output: Contribution to journalMeeting abstract

TY - JOUR

T1 - Management and outcome of cholesterol embolus identified in a diabetic retinopathy screening program

AU - Whitehouse, K.

AU - Dodson, P.M.

N1 - Abstracts of the 21st Meeting of the European Association for the Study of Diabetes Eye Complications Study Group (EASDEc)

PY - 2011/4/15

Y1 - 2011/4/15

N2 - Purpose. We examined the incidence, management, and outcomes of patients known to be at high cardiovascular risk, and to assess whether specialist referral to an ophthalmic medical clinic is worthwhile. Methods. Patients in the East Birmingham area with cholesterolembolus who were identified on digital diabetic retinopathy screening over a 3-year period were referred to a specialist ophthalmic medicine clinic within Heart of England NHS Trust for management and investigation. Results. A total of 33 patients were referred for clinical management.(male:female = 22:11, mean age 72 years). A total of 28 patients were known to be receiving medication: 14 anti hypertensive therapy(42%), 19 aspirin (59%), and 21 statin (64%). A total of 18 patients had known cardiovascular disease, 10 of whom had received carotid stenting or coronary artery bypass surgery. Ten patients diagnosed with embolus required and consented to carotid Doppler studies. Six patients were confirmed with significant carotid stenosis and 2 (6%)of these patients required carotid endarterectomy surgery. Overall, 4patients died, a mortality rate of 12% over 3 years. Conclusions. Annual diabetic retinopathy screening provide sopportunistic identification of asymptomatic cholesterol emboli and provides an opportunity for review of medical management in the high-risk patient group with appropriate identification and referral for carotid stenosis surgery. A total of 11 patients were identified with sub optimal cardiovascular risk management: e.g., statin use.

AB - Purpose. We examined the incidence, management, and outcomes of patients known to be at high cardiovascular risk, and to assess whether specialist referral to an ophthalmic medical clinic is worthwhile. Methods. Patients in the East Birmingham area with cholesterolembolus who were identified on digital diabetic retinopathy screening over a 3-year period were referred to a specialist ophthalmic medicine clinic within Heart of England NHS Trust for management and investigation. Results. A total of 33 patients were referred for clinical management.(male:female = 22:11, mean age 72 years). A total of 28 patients were known to be receiving medication: 14 anti hypertensive therapy(42%), 19 aspirin (59%), and 21 statin (64%). A total of 18 patients had known cardiovascular disease, 10 of whom had received carotid stenting or coronary artery bypass surgery. Ten patients diagnosed with embolus required and consented to carotid Doppler studies. Six patients were confirmed with significant carotid stenosis and 2 (6%)of these patients required carotid endarterectomy surgery. Overall, 4patients died, a mortality rate of 12% over 3 years. Conclusions. Annual diabetic retinopathy screening provide sopportunistic identification of asymptomatic cholesterol emboli and provides an opportunity for review of medical management in the high-risk patient group with appropriate identification and referral for carotid stenosis surgery. A total of 11 patients were identified with sub optimal cardiovascular risk management: e.g., statin use.

U2 - 10.5301/EJO.2011.6363

DO - 10.5301/EJO.2011.6363

M3 - Meeting abstract

VL - 21

SP - 350

EP - 351

JO - European Journal of Ophthalmology

JF - European Journal of Ophthalmology

SN - 1120-6721

IS - 3

ER -