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Maxwell Stem, Nidhi Talwar, Grant M. Comer, Joshua D. Stein; A Longitudinal Analysis of Risk Factors for Central Retinal Vein Occlusion. Invest. Ophthalmol. Vis. Sci. 2012;53(14):992.
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© ARVO (1962-2015); The Authors (2016-present)
To identify risk factors associated with the development of central retinal vein occlusion (CRVO) among a diverse group of patients throughout the United States
All beneficiaries age ≥55 years who were continuously enrolled in a large managed care network for at least 2 years and who had ≥2 visits to an eye care provider from 2001-2009 were identified. ICD-9-CM billing codes were used to identify individuals who were newly diagnosed with a CRVO. Multivariable Cox regression was performed to determine sociodemographic factors, medical, and ocular comorbidities associated with CRVO.
Of the 494,165 enrollees who met the study inclusion criteria, 1,302 (0.26%) experienced a CRVO. After adjustment for confounders, blacks had a 57% increased hazard of developing a CRVO compared with whites (adjusted hazard ratio (aHR)=1.57 [95% confidence interval (CI): 1.25-1.98]) and females had a 24% decreased hazard of CRVO compared with males (aHR=0.76 [95% CI: 0.67-0.85]). Individuals with metabolic syndrome (diabetes mellitus (DM), hypertension (HTN), and hyperlipidemia) had a 57% increased hazard of CRVO relative to those without any of these conditions (aHR=1.57 [95% CI: 1.11-2.23]). A history of stroke increased the hazard of developing a CRVO by 45% (aHR=1.45 [95% CI: 1.24-1.70]) and hypercoagulable state was associated with a 146% increased hazard of experiencing a CRVO (aHR=2.46 [95% CI: 1.41-4.29]). Those with uncomplicated HTN had a 36% increased hazard of CRVO (aHR=1.36 [95% CI: 1.11-1.67]) while individuals with end-organ damage from HTN had a 90% increased hazard of CRVO (aHR=1.90 [95% CI: 1.50-2.41]) compared to those without HTN. Patients with uncomplicated DM did not have an increased hazard of CRVO (aHR=0.87 [95% CI: 0.73-1.04]) but individuals with end-organ damage from DM had a 53% increased hazard of CRVO (aHR=1.53 [95% CI 1.28-1.84]) compared to those without DM.
This study confirms that the metabolic syndrome and vascular diseases are important risk factors for CRVO. We also identify new risk factors for CRVO including black race and male sex. Using the information from this analysis, researchers can create a risk calculator to identify individuals who are at highest risk for CRVO and those who would most benefit from primary prevention strategies.
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