Associations between retinal vein occlusions and cardiovascular disorders: a prospective nationwide registry-based case-control study

Abstract

Purpose : In a prospective, nationwide, registry-based case-control study, we aimed to evaluate the occurrence of retinal vein occlusion (RVO) and the risk of subsequently developing cardiovascular disorders (CVD).

Methods : Data were collected from the Danish National Patient Registry. RVO patients diagnosed at any Danish ophthalmology clinic were included from 1. January 1998 to 31. December 2018 and compared with ten sex- and age-matched controls. No previous record of RVO or CVD before 1. January 1998 was allowed. Cardiovascular disorders were sorted into three groups: ischemic CVD, non-ischemic CVD and venous occlusions.
We used a Cox proportional hazards model adjusted for sex and age at RVO to calculate hazard ratios (HR) with 95% confidence intervals (CI) for the associations between RVO and CVD. We used days from date of first registered RVO as underlying time scale. Patients were followed until the earliest registration of CVD, death, migration or end of follow-up, whichever occurred first.

Results : We included 4091 patients with RVO, comprising 1482 (36.2%) central RVO (CRVO), 1918 (46.9%) branch RVO (BRVO), and 691 (16.9%) anatomically unspecified RVO. Patient characteristics were: 49.7% males and age 66.9±12.9 yrs. Where affected eye was specified (n=2664), 48.9% were right eye, 48.4% were left eye, and 2.7% were bilateral.
Hazard ratios for subsequent development of CVD among RVO patients were 1.13(1.02-1.26) for ischemic CVD, 1.40(1.31-1.50) for non-ischemic CVD and 1.22(0.97-1.53) for venous occlusions. In a subgroup analysis of CRVO and BRVO we found increased HR for non-ischemic CVD (CRVO 1.24(1.10-1.39) and BRVO 1.56(1.41-1.71)), but no increased HR for ischemic CVD (CRVO 1.08(0.91-1.29) and BRVO 1.16(0.99-1.36)) or venous occlusions (CRVO 1.33(0.94-1.89) and BRVO 0.99(0.67-1.45)).
Among systemic venous occlusions, the HR for subsequent development of pulmonary embolism was increased in CRVO (1.77(1.16-2.71)) whereas no increased HR was found for deep venous thrombosis, cerebral venous thrombosis or chronic thromboembolic pulmonary hypertension in either RVO group.

Conclusions : In our prospective nation-wide case-control study of patients with RVO, we found increased risk of subsequent development of ischemic CVD, non-ischemic CVD and venous occlusions. Within venous occlusions, we found increased risk of pulmonary embolism in CRVO patients.

This is a 2020 ARVO Annual Meeting abstract.