Abstract WP176: Demographic and biochemical data are good predictors of visual outcome after acute retinal artery occlusion

Introduction: Acute retinal artery occlusion is an ophthalmological emergency similar to acute ischemic stroke, and visual outcome after presentation may be heavily influenced by factors other than acute medical interventions. Identification of such factors can lead to improved management strategies in the future. Methods: From a retrospective multicenter registry, consecutive patients presenting with monocular vision loss were included. Logistic regression analysis is utilized to develop predictive models to identify factors affecting visual outcomes at follow-up. R 2 McF is utilized to select models with strong predictive value, as by convention, R 2 McF values of 0.2-0.4 are considered acceptable models and >0.4 are considered strong models. Results and Conclusions: From a total of 94 patients presenting with monocular vision loss, 74 patients had a final diagnosis of CRAO or BRAO. Only 42 patients had post-hospital follow-up. When comparing groups with different visual outcomes, no statistically significant difference was found in age, sex, BMI, vital signs, biochemical findings, interventions, specialty evaluation, stroke risk factors, and stroke etiologies. However, when comparing patients with visual worsening at follow-up, there was a statistically significant difference in racial distribution (p = 0.039), with Asian patients showing a higher tendency for poorer visual outcomes. When these factors are compared using binomial and multinomial logistic regression, the classical interventions like intravenous thrombolysis, hyperbaric oxygen therapy, and steroid therapy, along with stroke etiologies, especially embolic etiologies, as well as stroke preventive measures such as antiplatelets and anticoagulation, were associated with a higher likelihood of positive outcomes. Interestingly, sex and race were two factors with the highest impact on the likelihood of visual worsening at follow-up (R 2 McF =0.216). Including age and pre-morbid mRS slightly improved the model (R 2 McF =0.352). The best model to predict the likelihood of visual worsening included age, gender, race, diastolic (but not systolic) blood pressure, and erythrocyte sedimentation rate i.e., all the data available close to the time of presentation (R 2 McF =0.652, Model accuracy = 0.914, Specificity = 0.929, Sensitivity = 0.857). The underlying mechanism for how these factors affect visual outcomes after retinal artery occlusion should be studied in future prospective studies.