Factors Linked to Incidental Retinal Emboli in U.S. Adults

Journal Highlights

American Journal of Ophthalmology, January 2024

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Emboli of the retina may signal serious cardiovascular pathology. In regional studies, the prevalence of retinal emboli has varied (ranging from 0.3% to 2.9%), and data for the U.S. population are limited. In a recent study, Teebagy et al. used a nationally representative sample of adults to better define the prevalence of these emboli and to identify factors associated with them. They noted an overall rate of 0.7%, which was higher among the elderly and did not vary by sex or race/ethnicity. Smoking, low body mass index (BMI), and low household income raised the risk of incidental retinal emboli.

This cross-sectional study included people ≥40 years of age who participated in the 2005-2008 U.S. National Health and Nutrition Examination Survey. Incidental retinal emboli were identified from retinal fundus photography, and multivariable logistic regression was applied to explore relationships between retinal emboli and sociodemographic, lifestyle, and clinical factors. These included age, sex, race/ethnicity, education, BMI, household income, smoking status, level of alcohol use, and medical conditions such as hypertension, diabetes, and hypercholesterolemia.

Among the 5,764 adults (53% women), incidental retinal emboli occurred in 39 (0.7%). The survey-weighted prevalence increased with age, and ranged from 0.1% for those in the fifth decade of life to 1.4% for those ≥70 years. After adjustment for age and sex, the factors associated with incidental retinal emboli were low (underweight) BMI (odds ratio [OR], 7.24), tobacco use (OR, 6.16), household income <2 times the federal poverty level (OR, 4.41), and comorbid hypertension (OR, 2.67).

Most of these findings parallel those of earlier population-based studies, said the authors, including the Beaver Dam and Blue Mountains eye studies. However, two previously unidentified factors emerged from the present study: low nutritional status (underweight BMI) and low household income. “The increased health burden faced by socioeconomically disadvantaged individuals and the resulting impact on cardiometabolic health may contribute to the association between low household income and incidental retinal emboli,” said the authors. They recommend further investigation of the relationship between retinal emboli and socioeconomic and nutritional status, which they hope would lead to new opportunities to identify individuals at high risk of underlying cardiovascular disease.

The original article can be found here.