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Tony Yuan-Ting Chen, Siri Uppuluri, Marco A Zarbin, Neelakshi Bhagat; Systemic and Ocular comorbidities in Central Retinal Vein Occlusion Patients Older and Younger than 40 Years Old. Invest. Ophthalmol. Vis. Sci. 2020;61(7):1329.
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© ARVO (1962-2015); The Authors (2016-present)
Central retinal vein occlusion (CRVO) occurs more commonly in older adults. Many risk factors for CRVO in younger patients remain unclear and may differ from those in the older population. This retrospective, observational study uses the National Inpatient Sample (NIS) Database to evaluate the most common systemic and ocular diseases associated with newly diagnosed CRVO in two age groups – 40 and under and above 40.
NIS Database from the years 2002-2014 was used. All patients with primary admission diagnosis of CRVO were identified using diagnostic code in the International Classification of Diseases, Ninth Edition. The primary outcome was to evaluate the distribution of specific systemic and ocular conditions in patients with CRVO in younger (age 40 and under) and older (age 41 and above) populations. Chi square analysis was performed using IBM SPSS 23.
A total of 110 patients in the younger group (age 40 and under) and 795 patients in the older group (age 41 and above) were identified to have primary admission diagnosis of CRVO in the NIS database. In the older CRVO group, the most commonly associated systemic diseases include hypertension (83.6%), hyperlipidemia (29.8%), diabetes (19.8%), tobacco use (19.2%), glaucoma (12.4%), and obesity (11.1%). On the other hand, most common systemic conditions associated with CRVO in younger patients include systemic venous thrombosis (14.3%), diabetes (14.3%), tobacco use (14.0%), hypertension (13.9%), hypercoagulable states (13.6%), glaucoma (9.6%), and rheumatoid arthritis/collagen vascular diseases (9.6%). Among the risk factors studied, systemic venous thrombosis, hypercoagulable states, rheumatoid arthritis/collagen vascular disease, migraine, pseudotumor cerebri, and retinal vasculitis were significantly more common in younger patients compared to older adults.
Cardiovascular risk factors such as hypertension, diabetes, hyperlipidemia, obesity, and history of smoking are the most commonly associated comorbidities with CRVO in older patients. These risk factors, except for hyperlipidemia and obesity, are also commonly associated with CRVO in younger patients. Additionally, our study showed that hypercoagulable states, vascular disease, and inflammatory conditions are significantly more common in the younger group. Therefore, additional workup may be indicated for CRVO in this population.
This is a 2020 ARVO Annual Meeting abstract.
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