Clinical significance of retinal emboli during diagnostic and therapeutic cardiac catheterization in patients with coronary artery disease

BMC Cardiovasc Disord. 2011 Jan 21:11:5. doi: 10.1186/1471-2261-11-5.


Background: Cardiac catheterization may cause retinal embolization, a risk factor for cerebrovascular emboli and stroke. We describe the incidence of clinically silent and apparent retinal emboli following diagnostic and interventional coronary catheterization and associated risk factors.

Methods: Three hundred selected patients attending a tertiary referral center for diagnostic and therapeutic cardiac catheterization were studied. Retinal examination and examination of the visual field and acuity were done before and after catheterization by a retinal specialist.

Results: There were 5 case of retinal embolus before catheterization, and 19 patients (incidence 6.3%) developed new retinal arteriolar emboli after catheterization. Only 1 patient developed clinically apparent changes in vision. Two conventional risk factors (age and hypertension) were significantly associated with new retinal emboli. The risk of retinal emboli was also significantly associated with operator expertise.

Conclusions: Retinal embolism was found after coronary catheterization in 6.3% of our patients. This finding indicates that the retinal, and possibly the cerebral circulation, may be compromised more frequently than is clinically apparent as a complication of coronary catheterization. Age and hypertension are independent predictors of retinal embolism.

Trial registration: NCT01157338.

Publication types

  • Clinical Trial
  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Cardiac Catheterization* / adverse effects
  • Cohort Studies
  • Coronary Artery Disease / complications
  • Coronary Artery Disease / diagnosis*
  • Coronary Artery Disease / therapy*
  • Embolism / diagnosis*
  • Embolism / epidemiology
  • Embolism / etiology
  • Female
  • Humans
  • Hypertension / complications
  • Hypertension / diagnosis
  • Hypertension / therapy
  • Male
  • Middle Aged
  • Retinal Diseases / epidemiology
  • Retinal Diseases / etiology
  • Retinal Diseases / pathology*
  • Retinal Vessels / pathology*
  • Risk Factors

Associated data