RETINAL ARTERIAL ISCHEMIA, WHETHER TRANSIENT or permanent, is a form of anterior circulation ischemic stroke caused by decreased blood flow in the ophthalmic branches of the internal carotid artery. Transient ischemic attack (TIA), including transient monocular visual loss (so-called retinal TIA or amaurosis fugax), is well known to be a prodromal syndrome of ischemic stroke. Indeed, a TIA is a medical emergency associated with a high risk of early ischemic stroke and other cardiovascular events. Among patients with TIA, 10% to 15% have a stroke within 90 days, with approximately half occurring within 48 hours. Individuals who have had a TIA and survive the initial high-risk period have a 10-year stroke risk of approximately 19% and a combined 10-year stroke, myocardial infarction, or vascular death risk of 43% (4% per year).2 These findings highlight the need for the urgent referral of patients with TIA and acute ocular and cerebrovascular events so that they can access expert evaluations and immediate treatment.
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