The results of a 20-year multinational retrospective analysis suggest that patients with retinal vein occlusion (RVO) are at a greater risk of developing certain cardiovascular conditions compared to controls.
Study Design
An aggregated electronic health records research network (TriNetX) was used to evaluate the relative risk (RR) of stroke, myocardial infarction (MI), deep vein thrombosis (DVT), or pulmonary embolism (PE) in 45,304 patients with RVO compared to a control group of 45,304 patients with cataracts. Patients were propensity score–matched for age, sex, race, ethnicity, and systemic associations including hypertension, diabetes, and hyperlipidemia. Patients who had a previous diagnosis of stroke, MI, DVT, or PE within 2 years of diagnosis of RVO or cataract were excluded. Risk was assessed at 1, 5, and 10 years after diagnosis.
Outcomes
Compared to the patients in the control group, individuals in the RVO group had a higher RR of death at 1 year (RR: 1.30), 5 years (RR: 1.22), and 10 years (RR: 1.08) as well as a higher RR for stroke at each of the same time points (RR of 1.61, 1.33, and 1.18, respectively). Patients in the RVO group also had a higher RR for myocardial infarction compared to the control group at 1 year (RR: 1.26) and 5 years (RR: 1.13), but not at 10 years, and a higher RR for deep vein thrombosis at 1 year (RR: 1.65) but not at 5 years or 10 years. No increased RR of PE was observed in patients in the RVO group compared to the control group at any time points analyzed.
Limitations
This study has limitations that are intrinsic to all database studies in which there is reliance on correct coding of diseases to answer the clinical questions being studied.
Clinical Significance
This study underscores the importance of referring any patient diagnosed with RVO to their primary care providers for assessment of RVO risk factors in order to optimize their systemic cardiovascular health. Sharing the results of this study with patients may also help motivate them to adhere more to recommended treatment and screening regimens.
Financial Disclosures: Dr. Ajay Kuriyan discloses financial relationships with 4DMT, Adverum, Annexon, National Eye Institute, Novartis, Alcon Pharmaceuticals (Grant Support); Alimera Sciences, Allergan, Bausch + Lomb, EyePoint Pharmaceuticals (Consultant/Advisor); Iveric Bio, Optos (Lecture Fees/Speakers Bureau); Lumata Health, Recens Medical (Consultant/Advisor, Private Equity/Stock Holder); Spark Therapeutics (Consultant/Advisor, Lecture Fees/Speakers Bureau); Genentech (Consultant/Advisor, Lecture Fees/Speakers Bureau, Grant Support).