Risk of Retinal Vascular Occlusive Disease in Patients with Aortic Stenosis

IF 3.2 Q1 OPHTHALMOLOGY

Ophthalmology science Pub Date : 2025-04-11 DOI:10.1016/j.xops.2025.100795

Minjeong Kim MD , Eui-Young Choi MD, PhD , Kunho Bae MD , Ju-Yeun Lee MD, PhD

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Abstract

Objective

The intersection of aortic stenosis (AS) and retinal vascular occlusive disease (RVOD) underscores the need for comprehensive cardiovascular and ophthalmic evaluations in patients with either condition. We aimed to evaluate the risk of RVOD in the entire Korean population with AS.

Design

A population-based retrospective cohort study.

Participants

We included 4094 patients with AS (2088 males) and 4094 age-, sex-, and index year-matched controls. Clinical and follow-up data of all patients diagnosed with AS and healthy controls from 2004 to 2015 were extracted from the Korean National Health Insurance Claim database.

Methods

The risk of RVOD, including retinal vein occlusion and retinal artery occlusion, was compared between the AS and control groups. Competing analysis was used to obtain aHRs. The covariates used in the final analysis included age, sex, income, body mass index, fasting glucose, systolic blood pressure, cholesterol level, smoking, alcohol consumption, atrial fibrillation (AF), and myocardial infarction (MI).

Main Outcome Measures

Adjusted hazard ratio (aHR) of RVOD, incidence rate of RVOD.

Results

The incidence rate of RVOD per 100 000 was 495.3 in the AS group and 366.2 in the control group (P < 0.001). During a mean follow-up period of 8 years, the aHR of RVOD was 1.48 (95% confidence interval [CI]: 1.19–1.83) in the AS group compared with the control group. Even after adjusting for AF and MI, the incidence of RVOD remained consistently and significantly higher in patients with AS (aHR 1.29, 95% CI: 1.03–1.63). In the subgroup analysis based on age, the risk of RVOD was significantly higher in patients with AS across all age groups. However, this significance weakened after adjusting for MI in patients ≥80 years (aHR 7.47, 95% CI: 0.97–57.55) and for AF in patients ≥65 years (aHR 1.36, 95% CI: 0.92–2.03).

Conclusions

The results suggest a possible clinical association between AS and subsequent RVOD. Continuous screening for ≥5 years for RVOD would be recommended in patients with AS.

Financial Disclosure(s)

The author(s) have no proprietary or commercial interest in any materials discussed in this article.

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主动脉狭窄患者视网膜血管闭塞性疾病的风险

目的：主动脉瓣狭窄（AS）和视网膜血管闭塞性疾病（RVOD）的交叉强调了对这两种疾病患者进行心血管和眼科综合评估的必要性。我们的目的是评估整个韩国AS患者RVOD的风险。设计一项基于人群的回顾性队列研究。我们纳入了4094名AS患者（2088名男性）和4094名年龄、性别和指数年份匹配的对照组。从韩国国民健康保险索赔数据库中提取2004年至2015年诊断为AS的所有患者和健康对照者的临床和随访数据。方法比较AS组与对照组发生视网膜静脉闭塞和视网膜动脉闭塞的风险。采用竞争分析获得ahr。最终分析中使用的协变量包括年龄、性别、收入、体重指数、空腹血糖、收缩压、胆固醇水平、吸烟、饮酒、心房颤动（AF）和心肌梗死（MI）。主要观察指标：RVOD的校正危险比（aHR）、RVOD的发生率。结果AS组RVOD发生率为495.3 / 10万，对照组为366.2 / 10万(P <；0.001)。在平均8年的随访期间，AS组与对照组相比，RVOD的aHR为1.48（95%可信区间[CI]: 1.19-1.83）。即使在调整房颤和心肌梗死后，AS患者的RVOD发生率仍然持续且显著较高（aHR 1.29, 95% CI: 1.03-1.63）。在基于年龄的亚组分析中，所有年龄组的AS患者发生RVOD的风险都明显更高。然而，在调整≥80岁患者的心肌梗死（aHR 7.47, 95% CI: 0.97-57.55）和≥65岁患者的房颤（aHR 1.36, 95% CI: 0.92-2.03）后，这种显著性减弱。结论AS与随后的RVOD之间可能存在临床关联。建议AS患者连续筛查RVOD≥5年。财务披露作者在本文中讨论的任何材料中没有专有或商业利益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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