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  • Opioid Use Raises Risk of Retinal Vein Occlusion

    By Jean Shaw
    Selected by Emily Y. Chew, MD
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    Journal Highlights

    Ophthalmology Science, March 2022

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    McDermott et al. used the NIH’s All of Us database, which links to electronic medical records, to determine risk fac­tors for retinal vein occlusion (RVO). They found a previously uncharacterized association between opioid use and RVO.

    For this retrospective case-control study, the researchers evaluated data from All of Us (https://allofus.nih.gov) on 691 participants with RVO (380 with branch and 311 with central RVO) and another 1,520 participants, who served as controls. All were 18 years of age or older, and controls were proportionally matched to the demographic distribution of the 2019 U.S. census. Data were extracted regarding demographics, comorbidities, income, housing, insurance, and substance abuse. The main outcome measure was development of RVO based on diagnostic codes.

    Overall, patients with branch and central RVO shared medical risk factors, with traditional risk factors (e.g., glaucoma, hypertension, hyperlipidemia, and diabetes) linked to a greater risk of developing RVO. The results also indicated that older participants were at increased risk, as were those who were Black.

    With regard to substance use, past marijuana use was associated with a decreased risk of developing RVO. However, those who had used opioids were at increased risk (branch RVO = odds ratio [OR], 1.98; 95% confidence interval [CI], 1.41-2.78; central RVO = OR, 2.32; 95% CI, 1.59-3.41; p < .001 for both).

    The researchers noted that the results of previous studies have suggested that opioids may induce local microvascular or systemic cardiovascular changes that could lead to RVO. However, they noted, further studies—ideally those with larger cohorts and a prospective design—are needed.

    The original article can be found here.