Risk factors in central retinal vein occlusion: A multi-center case-control study conducted on the Italian population

Abstract

Purpose To explore the risk factors for central retinal vein occlusion (CRVO) by comparing a large sample of patients with healthy controls. Materials and Methods Multi-center case-control study. The study group includes patients affected by central retinal vein occlusion, confirmed angiographically, aged 50 years old or above (Group A). The control group includes healthy subjects without an history of retinal vein occlusion (Group B). Outcome measures: age, gender, active smoking, presence of uncontrolled arterial hypertension (uHTN), presence of the following comorbidities: diabetes mellitus type II (DMII), chronic liver disease (CLD), chronic kidney disease (CKD), thyroid disease (TD), systemic lupus erythematosus (SLE), hyperhomocystenemia (HHcy), dyslipidemia (DLip), carotid artery disease (CAD), glaucoma, atrial fibrillation (AF), migraine headache (MH), chronic obstructive pulmonary disease (COPD), obstructive sleep apnea syndrome (OSAS), history of myocardial infarction (MI). Odds-ratios were calculated with logistic regression analysis. Results A total of 203 patients (Group A) and 339 controls (Group B). Statistically-significant differences were found for the following variables: age (OR: 1.109 [1.081–1.138], p < .001), active smoking (OR: 2.048 [1.210- 3.466], p < .008), DMII (OR: 4.533 [2.097–9.803], p < .001), HHcy (OR: 4.507 [2.477–10.001 ], p < .001), DLip (OR: 2.255 [1.352–3.762], p = .002), CAD (OR: 6.632 [2.944- 14.942], p < .001), glaucoma (OR: 4.656 [2.031–10.673], < .001), OSAS (OR: 1.744 [1.023–2.975], < .041), uHTN (OR: 3.656 [2.247–5.949], < .001). No statistically-significant differences were found for the other variables. Conclusions Older age, active smoking, as well as presence of DMII, HHcy, DLip, CAD, glaucoma, OSAS, and uHTN, all increase the risk for CRVO. A comprehensive assessment of patients with CRVO is paramount. Adequate control of all the aforementioned risk factors is likely of great significance in reducing the incidence of CRVO among the general population, and it likely plays an important role in improving the prognosis following the occlusive event.

Retinale Gefäßverschlüsse als Ausdruck eines generalisierten Gefäßleidens

“…However, further research also highlights the need for a comprehensive assessment of cardiovascular risk factors. In an Italian analysis, in addition to nicotine abuse, poorly controlled arterial hypertension, diabetes mellitus type 2, dyslipidemia, carotid artery stenosis, and sleep apnea syndrome were found dispropor- tionately often in patients with RVO [40]. These findings are also consistent with the database analysis of over 23 million insured persons from Korea, who were monitored over a period of 4 years and for whom an increased risk of RVO in the presence of a metabolic syndrome was described (hazard ratio 1.46) [36].…”

“…Eine ältere Analyse hat ein erhöhtes Vorkommen noch verneint[34].Die Notwendigkeit einer umfassenden Beurteilung der kardiovaskulären Risikofaktoren ergibt sich aber auch aus weiteren Untersuchungen. In einer italienischen Analyse wurde neben dem Nikotinabusus auch ein nicht optimal eingestellter arterieller Hypertonus, ein Diabetes mellitus Typ 2, eine Dyslipidämie, eine Karotisstenose und ein Schlafapnoe-Syndrom überdurchschnittlich häufig bei Patienten mit RVV gefunden[40]. Diese Befunde passen auch zur Datenbankanalyse von über 23 Mio.…”

Research progress on diagnosing retinal vascular diseases based on artificial intelligence and fundus images

“…Retinal vein occlusion (RVO) is one of most common retinal vascular disease, second only to diabetic retinopathy, and more common in older patients ( Ren et al, 2022 ). The pathogenesis of RVO is related to many factors such as vascular endothelial damage, hemodynamic changes, intraocular pressure, and ocular local compression ( Terao et al, 2022 ; Trovato Battagliola et al, 2022 ). In addition, the disease is closely related to arteriosclerosis, cardiovascular and cerebrovascular diseases, hypertension, diabetes, and other risk factors ( Orskov et al, 2022 ; Tang et al, 2022 ).…”

Sleep-disordered breathing is related to retinal vein occlusion: A meta-analysis

“…[25] However, most of the previous studies that aimed to explore the relationship between SDB and RVO in adults were of limited scale and have rarely been comprehensively evaluated in a meta-analysis. [26][27][28][29][30][31][32] Therefore, we performed a meta-analysis to systematically observe the relationship between RVO and SDB and to explore whether the association is consistent for different types of RVO (CRVO and BRVO) and in patients with SDB of differing severity.…”

“…Subsequently, 25 additional studies were excluded for the reasons shown in Figure 1, which led to 7 studies being finally selected for inclusion in the meta-analysis. [26][27][28][29][30][31][32]…”