TOPLINE:

Patients with transient vision loss had elevated risks for major adverse cardiovascular events (MACEs), stroke, myocardial infarction, arrhythmia, and hospitalization within 14 days of the onset of sight problems, with risks persisting up to 10 years.

METHODOLOGY:

• Researchers conducted a retrospective cohort study using data from 71 healthcare organizations worldwide and assessed whether transient loss of vision was associated with short- and long-term cardiovascular problems.
• They included adults who had a first diagnosis of transient vision loss or amaurosis fugax between June 2005 and June 2025. Adults with a first diagnosis of dry eye syndrome were considered control individuals.
• After propensity score matching, the final analysis included 37,750 patients with transient vision loss (mean age, 56.8 years; 59.7% women) and 37,750 control individuals (mean age, 56.6 years; 58.9% women).
• The primary outcomes, assessed within 14 days of the index event, included MACE, stroke, myocardial infarction, arrhythmias, venous thromboembolism, hospitalization, and all-cause mortality.
• Secondary outcomes included the incidence of cardiovascular events at 30 days, 90 days, and up to 10 years.

TAKEAWAY:

• Patients with transient vision loss had markedly higher risk for MACE at 14 days than control individuals (adjusted hazard ratio, 9.80; 95% CI, 7.19-13.34).
• At 14 days, patients with transient vision loss had elevated risks for stroke (21.7-fold), myocardial infarction (fivefold), arrhythmia (4.01-fold), and hospitalization (3.83-fold).
• At 10 years, patients with transient vision loss had increased risks for MACE (1.6-fold), stroke (1.99-fold), arrhythmia (1.67-fold), myocardial infarction (1.47-fold), and hospitalization (1.35-fold).
• The risk for venous thromboembolism increased modestly at 90 days, with no elevation at 5 years, and all‑cause mortality did not differ between groups at any time.

IN PRACTICE:

“Our findings suggest that when TVL [transient vision loss] is suspected to be vascular, particularly among patients with underlying vascular risk factors or lacking an alternative benign explanation, assessment should carry the same diagnostic urgency as cerebral TIA [transient ischemic attack] due to the comparable early risk trajectory,” the researchers reported.

“We highlight the first 90 days as a critical window where the risk of stroke, MACE, MI [myocardial infarction], and arrhythmia is greatest, and urgent intervention is most impactful,” they added.

SOURCE:

This study was led by Tasha Miller of University of Toronto, Toronto, Ontario, Canada. It was published online on December 9, 2025, in the British Journal of Ophthalmology.

LIMITATIONS:

This study relied on diagnostic codes and did not confirm an ischemic cause or describe visual symptoms in detail. Nonischemic causes of transient vision loss may have been included despite excluding patients with prior vascular events. The findings may not be generalized to non-Western settings.

DISCLOSURES:

This study did not receive any specific funding. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.