JAN 12, 2016
By Howard Pomeranz, MD
An extensive database analysis finds that patients with retinal vein occlusion (RVO) are at an increased risk for stroke, especially during the first 30 days after the episode, leading the authors to recommend all patients undergo immediate risk evaluation and proper preventative treatment for cardiovascular diseases to reduce mortality and morbidity following RVO.
While other studies have shown an increased risk of stroke and cardiovascular disease following RVO, this is the only study to assess the risk period of cardiovascular disease before and after RVO. Using data from the Korean national claims database, which covers the entire Korean population of 48 million, the authors analyzed the incidence and risk for stroke and acute myocardial infarction with RVO. Among the 44,603 patients with incident RVO, 1,176 (2.6%) experienced stroke or acute myocardial infarction (AMI) within the first year after RVO occurrence.
The risk of stroke/AMI was significantly increased 6 months prior to and almost a year following RVO, and was highest in the first 30 days after the incident (IRR 2.66). Additionally, subgroup analysis showed that incidence of hemorrhagic stroke (IRR 3.45) was higher compared to ischemic strokes (IRR 2.87) at 30 days. The authors did not detect any increased risk when the analysis was limited to AMI.
Previous studies show mixed results. One study in Taiwan (2009) found no association between RVO and stroke. Two population-based studies support this database analysis: A U.S.-based study found a 2-fold risk of cerebral vascular accidents (2011) and a recent study including more than 1 million Koreans found patients were at a 50% higher risk of stroke in the 5 years following RVO (2015).