Transient retinopathy in acute aortic dissection.

Purpose: To explore the occurrence of transient retinopathy and its prognostic importance in patients with acute aortic dissection (AAD).
Design: Prospective, observational study.
Participants: Sixty-four patients with Stanford type B AAD were treated with conservative medical therapy.
Methods: Retinopathy findings, such as cotton-wool spots and hemorrhage, were examined. Fundus photography was performed on hospital days 9 to 14 and after 2 or 3 months. The association between the appearance of retinopathy and the subsequent cardio-cerebrovascular events was investigated.
Main Outcome Measures: The primary outcomes included the incidence of retinopathy and subsequent adverse cardio-cerebrovascular events.
Results: Retinopathy was detected in 55% (35 of 64) of patients (cotton-wool spots alone, n = 31; dot hemorrhage alone, n = 1; and both, n = 3). These findings disappeared in all 12 patients who underwent follow-up fundus examinations. In the multivariate analysis, a history of hypertension and higher peak C-reactive protein level were independently associated with retinopathy. At a median follow-up of 911 days, adverse cardio-cerebrovascular events were reported in 11 patients, of whom those with retinopathy experienced adverse events significantly more frequently than those without retinopathy (P = 0.045).
Conclusions: Retinopathy occurred frequently in patients with AAD. This retinopathy was associated with a history of hypertension and higher peak C-reactive protein levels and was an important predictive factor for adverse cardio-cerebrovascular outcomes.
(Copyright © 2014 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)