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Kyungsik Lee, Ki Heon Nam, Dong Wook Kim, Eui Chun Kang, Hyoung Jun Koh; Risk of Retinal Vein Occlusion in Patients with End Stage Renal Disease: An 11-Year, Retrospective Nationwide Cohort Study in South Korea. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1505.
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End stage renal disease (ESRD) is a known risk factor for systemic cardiovascular disease. As retinal vein occlusion (RVO) also is one of the vascular diseases, we can predict that ESRD can be a risk factor for developing of RVO, including central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO). The aim of this study is to evaluate the risk of RVO following ESRD.
We performed a retrospective, nationwide, propensity score-matched cohort study reviewing a data from the 11-year longitudinal Korean National Health Insurance Service database, comprising approximately 1 million random subjects. ESRD and RVO group were composed of patients with disease codes based on the International Classification of Diseases (ICD)-10 (ESRD: N18, RVO: H34.8). The ESRD group was comprised of patients with an initial diagnosis of ESRD from 2003 to 2005 (n=1123), excluding patients diagnosed in 2002. Control group was comprised of randomly selected propensity score-matched patients without ESRD diagnosis (4 for each patient with ESRD, n=4492) from the same period with ESRD group. Each patient of the two groups was followed up until December 2013, and the incidence and risk of RVO were compared between the two groups. After adjustment for possible confounders including diabetes mellitus, hypertension, hyperlipidemia and heart failure, the adjusted hazard ratio (HR) for RVO was obtained using Cox proportional hazard regression analysis.
RVO developed in 30.9 % patients of the ESRD group and 17.0 % those of the control group during the follow-up period (P<0.0001). ESRD was associated with a greater risk of RVO development after adjusting for possible confounders (HR, 1.216; 95% CI, 1.061 – 1.394, P=0.005). Other significant risk factor for RVO included the male gender (HR,1.193; 1.057-1.346), hyperlipidemia (adjusted HR, 1.681; 95% CI, 1.477-1.912), heart failure (adjusted HR, 2.021; 95% CI, 1.728-2.365), hypertension (adjusted HR, 3.609; 95% CI 2.973-4.381), DM (adjusted HR, 1.23; 95% CI 1.079-1.401) and high household income (81~100% group, adjusted HR, 1.217; 95% CI, 1.006-1.471).
An association between ESRD and subsequent RVO development was found after adjusting for possible confounding factors. For ESRD patients, more concern for RVO development is needed and strict lipid, blood pressure, glucose control should be educated.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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