The laterality difference of retinal vascular occlusion

Abstract

Purpose : Retinal vascular occlusion is one of the leading causes of profound irreversible visual loss. It was reported in a small-scale study that right eyes were more commonly involved in retinal artery occlusion (RAO). We systematically investigate laterality characteristics in various subtypes of RAO as well as retinal vein occlusion (RVO) in the American Academy of Ophthalmology's IRIS^® Registry comprising 60 million ophthalmic patients.

Methods : All patients with laterality specified ICD-10 retinal vascular occlusion onset diagnoses were included. The percentages of patients with different subtypes of retinal occlusion in left eye, right eye and both eyes were calculated. The following subtypes were considered: Transient retinal artery occlusion (TRAO), central retinal artery occlusion (CRAO), partial retinal artery occlusion (PRAO), retinal artery branch occlusion (BRAO), central retinal vein occlusion (CRVO), venous engorgement and tributary (branch) retinal vein occlusion (BRVO) based on ICD-10 code. Binominal tests and Chi-square tests with the null hypothesis of 0.5 were performed to assess laterality difference and their possible interaction with sex, respectively.

Results : 19,633 patients were included and divided into different diagnosis subtypes. The population and percentage of each subtype are presented in Table 1. The most frequent diagnosis was BRVO in 29.13% of the whole cases, followed by BRAO and CRVO with 21.65% and 16.74% respectively. Retinal vascular occlusion was initially diagnosed in one eye in most cases (Table 1). Table 2 shows the specific lateralities among these unilateral onset cases. For artery occlusions, we found significant right-eye onset preferences in three subtypes (CRAO, PRAO, BRAO), with the same tendency for TRAO (but here only significant for men). Vein occlusions, on the other hand, presented a significant left-eye preference for two of the three subtypes (CRVO and venous engorgement), while for the third subtype (BRVO), no significant effects were found. Sex-specific laterality effects were generally in accordance with the effects in the entire population (see Table 2 for details).

Conclusions : There was significant right-eye preference in RAO and left-eye preference in RVO in most of retinal vascular occlusion subtypes in a large registry population.

This is a 2020 ARVO Annual Meeting abstract.

 

Table 1. Case frequency of retinal vascular occlusion

 

Table 2. Laterality difference of retinal vascular occlusion for unilateral onset cases