Article Impact Level: HIGH Data Quality: STRONG Summary of American Journal of Ophthalmology, 257, 129–136. https://doi.org/10.1016/j.ajo.2023.08.022 Dr. Karen M. Wai et al.
Points
- The research paper investigates the rates of stroke, myocardial infarction (MI), deep vein thrombosis (DVT), pulmonary embolism (PE), and mortality in patients following retinal vein occlusion (RVO) compared to a control group.
- A retrospective cohort study involving 45,304 patients in each cohort utilized propensity score matching to account for baseline demographics and medical comorbidities.
- Results revealed an increased risk of death, stroke, and MI in the RVO cohort at various intervals, with mortality and stroke risks remaining elevated for up to 10 years.
- Mildly elevated DVT risk was observed at one year but not at 5 or 10 years, and there was no elevated risk of PE at any time.
- The findings underscore the importance of long-term systemic evaluation following an RVO diagnosis due to the increased risk of specific cardiovascular events and mortality.
Summary
The research paper aimed to investigate the incidence rates of stroke, myocardial infarction (MI), deep vein thrombosis (DVT), pulmonary embolism (PE), and mortality in patients following a diagnosis of retinal vein occlusion (RVO) when compared to a control group. This retrospective cohort study utilized an aggregated electronic health records research network, TriNetX (Cambridge, MA, USA), to identify patients diagnosed with RVO and a control group comprising cataract patients. Exclusion criteria included a history of stroke, MI, DVT, or PE within two years of the RVO or cataract diagnosis, with propensity score matching applied to account for baseline demographics and medical comorbidities. The primary outcomes measured were the relative risk (RR) of death, stroke, MI, DVT, and PE after RVO compared to matched controls.
The study encompassed 45,304 patients in each cohort. The RVO cohort exhibited an elevated risk of mortality in comparison to the control cohort at one year (RR: 1.30, p<0.01), five years (RR: 1.22, p<0.01), and ten years (RR: 1.08, p<0.01). Elevated risks of stroke were observed at one year (RR: 1.61, p<0.01), five years (RR: 1.31, p<0.01), and ten years (RR: 1.18, p<0.01). Additionally, an increased risk of MI was evident at one year (RR: 1.26, p<0.01) and five years (RR: 1.13, p<0.01), although no statistically significant increase was noted at ten years (RR: 1.06, p=0.12). A mild elevation in the risk of DVT was observed at one year (RR: 1.65, p<0.01) but not at five years (RR: 0.94, p=0.94) or ten years (RR: 1.05, p=0.37). Notably, there was no elevated risk of PE at one year (RR: 0.98, p=0.80), five years (RR: 0.95, p=0.42), or ten years (RR: 0.85, p=0.40).
In conclusion, the study findings indicated an increased incidence of death, stroke, and MI in patients with RVO compared to their matched controls. These results underscore the necessity for a comprehensive, long-term systemic evaluation following an RVO diagnosis.
Link to the article: https://www.ajo.com/article/S0002-9394(23)00352-5/pdf
References Wai, K. M., Ludwig, C. A., Koo, E., Parikh, R., Mruthyunjaya, P., & Rahimy, E. (2024). Risk of stroke, myocardial infarction, deep vein thrombosis, pulmonary embolism, and death after retinal vein occlusion. American Journal of Ophthalmology, 257, 129–136. https://doi.org/10.1016/j.ajo.2023.08.022
