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. 2023 Mar;37(4):764-767.
doi: 10.1038/s41433-022-02038-x. Epub 2022 Apr 11.

Retinal vein occlusion is associated with stroke independent of underlying cardiovascular disease

Christine Y Bakhoum  1 , Samantha Madala  2 , Christopher K Long  3 , Fatemeh Adabifirouzjaei  4 , William R Freeman  5 , Michael H Goldbaum  5 , Anthony N DeMaria  4 , Mathieu F Bakhoum  6   7   8
Affiliations

Retinal vein occlusion is associated with stroke independent of underlying cardiovascular disease

Christine Y Bakhoum et al. Eye (Lond). 2023 Mar.

Abstract

Background: Stroke is a leading cause of mortality and morbidity. Thus, identifying associated risk factors may lead to earlier interventions aimed at reducing the risk of stroke development. Since cardiovascular disease simultaneously increases the risk of stroke and retinal vein occlusion (RVO), we sought to determine whether RVO is associated with the risk of stroke independent of underlying cardiovascular co-morbidities.

Methods: In this cross-sectional study, we reviewed the records of 80,754 individuals who were evaluated by an ophthalmologist over a 6-year period. We identified individuals with RVO, stroke and cardiovascular diseases including hypertension, diabetes mellitus, carotid disease, coronary artery disease and atrial fibrillation. Multivariable logistic regression models were used to analyze odds ratios for RVO and stroke.

Results: After adjusting for age, sex, cardiovascular disease and other risk factors, we found that the presence of RVO was associated with an odds ratio for stroke of 1.73 (CI, 1.40-2.12, p < 0.001). The association between RVO and stroke, after adjusting for sex and cardiovascular co-morbidities, was significantly stronger in individuals younger than 50 years of age, with an odds ratio of having a stroke of 3.06 (1.34-6.25, p < 0.001), while the presence of RVO in individuals older than 85 years was not significantly associated with stroke 1.19 (0.77-1.79, p = 0.41).

Conclusions: Our findings demonstrate that RVO is significantly associated with stroke, even after adjusting for underlying cardiovascular co-morbidities. This association was highly significant in younger subjects, while not significant in older individuals.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Frequencies of retinal vein occlusions and stroke.
A Percentage of individuals with stroke in those with and without RVO. Statistical significance tested using χ2. B Percentage of individuals with stroke and RVO across different age groups. RVO retinal vein occlusions.
Fig. 2
Fig. 2. Odds ratio for stroke.
A A multivariable logistic regression model for the presence of stroke. Covariates include RVO, cardiovascular disease, cardiovascular risk factors, age and sex. Reference age group is individuals less than 50 years of age. B Multivariable logistic regression models for the presence of stroke in each age group, using RVO as a predictor, and after adjusting for the same covariates. Error bars represent 95% confidence intervals. RVO retinal vein occlusions.
See this image and copyright information in PMC

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