Abstract
Purpose :
It is unclear whether the occurrence of retinal artery occlusion (RAO) increases the prevalence of coronary artery disease (CAD) when risk factors are adjusted at the time of diagnosis. We performed a retrospective case-control study to evaluate whether RAO is a predictive factor for subclinical CAD.
Methods :
A total of forty-one patients with non-arteritic RAO and 164 age- and sex-matched controls were retrospectively analyzed. The RAO group was composed of patients with an initial diagnosis of either central or branch RAO who underwent coronary computed tomographic angiography (CCTA) for the systemic atherosclerotic evaluation between 2004 and 2014. The control group consisted of 4-fold subjects who were randomly selected from the asymptomatic subjects who underwent CCTA as a part of general health evaluation. CCTA data including coronary artery calcium score, coronary atherosclerotic plque presence, severity, and compositionwere compared between RAO patients and control groups. Multiple logistic regressions were analyzed to assess risk factors associated with subclinical CAD.
Results :
Cardiovascular risk factors including age, sex, hypertension, diabetes mellitus, dyslipidemia, obesity, and smoking history were not significantly different between RAO patients and control groups. RAO patients demonstrated significantly higher calcium score (267.86 ± 674.93) compared to control subjects (120.22 ± 289.51) (p=0.034), and higher prevalence of subclinical CAD of ≥50 % diameter stenosis (29% vs. 15%, p=0.028) on CCTA. Segment-involvement score (p=0.032) and segment-stenosis score (p=0.016) were also significantly high in RAO patients than controls. Multiple logistic regression analysis revealed factors associated with subclinical CAD of ≥50% DS: age≥ 70 years (OR=5.5; 95% confidence interval (CI)=[2.3-13.1]), male sex [OR, 4.6 [1.4-14.3], diabetes (OR, 5.2 [2.1-12.9]), and central RAO (OR, 3.6 [1.3-9.7]).
Conclusions :
RAO patients had more subclinical CAD of ≥50% stenosis than age- and sex-matched controls. Higher Segment-involvement score and Segment-stenosis score in RAO patients suggest extensive and heavier burden of plaque in RAO patients compared to the control group in subjects with abnormal CCTA findings. The presence of RAO, especially CRAO was an independent predictive factor of abnormal CCTA findings suggesting subclinical CAD.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.