The GEIR (Grupo español de Ictus Retina) Registry: Rationale and Design of the First Nationwide Multicentre Retinal Stroke Registry in Spain (GEIR)

Despite growing recognition of retinal artery occlusion as the ocular equivalent of acute ischaemic stroke, important uncertainties remain regarding its epidemiology, pathophysiology, healthcare delivery, retinal viability and optimal treatment strategies. Current evidence is largely derived from retrospective cohorts, single-centre studies and a limited number of randomised clinical trials. Furthermore, no nationwide multicentre retinal stroke registry currently exists in Spain. The GEIR Registry was established to address these knowledge gaps through the creation of a national clinical and translational research platform dedicated to retinal stroke.

Methods and analysis The GEIR Registry is a nationwide, multicentre, ambispective observational registry comprising retrospective and prospective data collected from participating hospitals throughout Spain.

Consecutive patients presenting with retinal stroke, including central retinal artery occlusion, branch retinal artery occlusion, cilioretinal artery occlusion and paracentral acute middle maculopathy, are eligible for inclusion.

Clinical information is collected using a the institution's REDCap electronic data base specifically designed for the registry and includes demographic characteristics, vascular risk factors, acute stroke pathway metrics, neurovascular investigations, reperfusion therapies, laboratory biomarkers, secondary prevention strategies, neurological outcomes, ophthalmological assessments and longitudinal optical coherence tomography (OCT) biomarkers.

The registry aims to characterise retinal stroke epidemiology, healthcare delivery and long-term outcomes, while providing a unique platform for investigating retinal ischaemia, imaging biomarkers of retinal viability and predictors of visual recovery. Statistical analyses include descriptive epidemiological analyses, multivariable regression models and longitudinal outcome assessments.

Ethics and dissemination The registry will be conducted in accordance with the Declaration of Helsinki, applicable European and Spanish data protection regulations and local ethics committee approvals. Written informed consent will be obtained for prospective participants. Data will be pseudonymised and stored within a secure REDCap infrastructure.

Results generated from the registry will be disseminated through peer-reviewed publications, scientific conferences and collaborative multicentre research initiatives. The GEIR Registry is intended to serve as a long-term national infrastructure supporting clinical, epidemiological and translational research in retinal stroke.