Abstract
Purpose :
Retinal vascular occlusions are associated with cardiovascular disease. However, the association of retinal vascular occlusions with different subtypes of cardiovascular disease is not well defined. Additionally, whether retinal vascular occlusions are associated with higher risk of stroke independent of underlying cardiovascular disease is unknown.
Methods :
In this cross-sectional study, we reviewed the records of 98,202 individuals who were evaluated by an ophthalmologist or an optometrist at our institution for different clinical indications from July 1, 2015 until July 1, 2020. We identified individuals with retinal vascular occlusions, stroke and cardiovascular diseases including hypertension, diabetes mellitus (DM), carotid disease, coronary heart disease (CHD) and atrial fibrillation (AF) through billing diagnosis codes. All statistical analyses were performed using IBM SPSS version 26. Logistic regression models were used to analyze odds ratios for retinal vascular occlusions and stroke with 95% confidence intervals. Differences between two and three groups were analyzed with Pearson-Chi Square and one-way ANOVA tests, respectively.
Results :
The following cardiovascular diseases were significantly associated with retinal vascular occlusion: carotid disease (OR, 3.0; CI 2.5 – 3.6), hypertension (OR, 2.1; CI 1.9 – 2.4) and DM (OR, 1.5; CI 1.3 – 1.7). CHD and AF were not significantly associated with retinal vascular occlusion. Females had lower odds of retinal vascular occlusion (OR, 0.88; CI 0.79 – 0.98). After adjusting for age, sex and underlying cardiovascular co-morbidities, we found that presence of retinal vascular occlusion was associated with an odds ratio for stroke of 2.2 (CI 1.9 – 2.7). The association between retinal vascular occlusion and stroke was significantly higher in individuals younger than 40 years of age, with an odds ratio for stroke of 8.4 (CI 3.6 – 19.6, p < 0.001), even after adjusting for sex, hypertension, DM, carotid disease, AF and CHD.
Conclusions :
Our findings demonstrate a strong association between retinal vascular occlusion and carotid artery disease, hypertension and DM. Our results also demonstrate that retinal vascular occlusion is significantly associated with stroke, and more strongly so in younger subjects. Individuals who present with retinal vascular occlusion warrant further evaluation for underlying cardiovascular disease and stroke prevention.
This is a 2021 ARVO Annual Meeting abstract.