Practice patterns after acute embolic retinal artery occlusion

Purpose: To compare stroke evaluations recommended by retina specialists and neurologists for retinal artery occlusion (RA O). Design: A cross-sectional survey. Methods: An anonymous survey was emailed to members of the American Academy of Neurology Stroke Section listserv and vitreoretinal specialists registered with the American Academy of Ophthalmology. The survey was divided based on duration of symptoms before encounter: less than 12 hours, 24-48 hours, and more than 1 week. Institutional review board approval was obtained before data collection. Results: Four hundred forty-eight surveys were completed (281 retinologists and 167 neurologists). Within 12 hours of RA O, most neurologists (75%) pursue a hospital-based evaluation, whereas the majority of retinologists (82%) pursue outpatient workup (P < 0.0001). Most neurologists (92%) and retinologists (98%) pursue outpatient stroke workup if symptoms have been present for more than 7 days. Conclusions: Neurologists pursue higher acuity care after RA O, whereas most retinologists order outpatient evaluations. Retina specialists should consider urgent stroke evaluation to mitigate stroke risk factors.