ABSTRACT NUMBER: ESOC2026A2226 ADVANCED PRACTICE NURSE–LED TIA ASSESSMENT IN AN OPHTHALMOLOGIC EMERGENCY DEPARTMENT

Abstract Background and aims Early management of transient ischemic attack (TIA) reduces the risk of subsequent stroke. Patients presenting with transient visual symptoms are frequently evaluated in ophthalmologic emergency departments (EDs), where distinguishing cerebrovascular events from primary ocular disorders can be challenging. As one of only two hospitals in Paris providing 24/7 ophthalmologic emergency care, our institution represents a major entry point for patients with suspected cerebrovascular symptoms, prompting implementation of a structured TIA care pathway. Methods In January 2024, a structured TIA clinic was implemented within the neurology department, supported by an advanced practice nurse (APN) including a dedicated telephone line for community physicians. From June 2024 onward, this pathway was extended to the ophthalmologic ED. Adult patients (≥18 years) presenting during working hours with transient visual and/or neurological symptoms underwent APN assessment, followed by case discussion with a stroke neurologist. Neuroimaging was performed when indicated, and final diagnosis and treatment decisions were made by the stroke neurologist. Results Between January 2024 and December 2025, 280 patients were evaluated, including 154 (55%) with transient visual symptoms. Overall, 118 patients (42%) were diagnosed with TIA and 30 (11%) with acute ischemic stroke. Among patients presenting directly to the ophthalmologic ED (n=145), 74% had visual symptoms, with TIA and stroke diagnosed in 48% and 9%, respectively. Conclusions Integration of an APN-coordinated TIA clinic into a 24/7 ophthalmologic ED is. and identifies a substantial burden of cerebrovascular disease among patients with transient visual symptoms Conflict of interest Nothing to disclose