Retinal Vein Occlusion and Vascular Mortality: Pooled Data Analysis of 2 Population-Based Cohorts
Received 2 March 2006; accepted 22 June 2006. published online 01 December 2006.
Purpose
To assess the association of retinal vein occlusion (RVO) with cardiovascular and cerebrovascular mortality.
Design
Pooled data from 2 population-based cohort studies.
Participants
At baseline, the Beaver Dam Eye Study (BDES) examined 4926 persons aged 43 to 86 years (from 1988–1990) and the Blue Mountains Eye Study (BMES) examined 3654 persons aged 49 to 97 years (from 1992 to 1994).
Methods
Retinal vein occlusion was assessed from retinal photographs. Vascular deaths were determined using either death certificates (BDES) or the Australian National Death Index (BMES). Cox regression analysis was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).
Main Outcome Measure
Vascular (cardiovascular and cerebrovascular) mortality was determined.
Results
Of 8384 baseline participants, 96 (1.14%) had RVO at baseline (BDES, n = 38; BMES, n = 58). Over 12 years, 1312 (15.7%) died of cardiovascular-related conditions and 341 (4.1%) died of cerebrovascular-related conditions. Age-standardized vascular mortality rates were 26.0% and 5.3%, respectively, in persons with RVO and 17.1% and 4.5%, respectively, in those without RVO. After adjusting for age, gender, body mass index, hypertension, diabetes, smoking, glaucoma, and study site, RVO was not associated with cardiovascular-related mortality (HR, 1.2; 95% CI, 0.8–1.8) or cerebrovascular-related mortality (HR, 0.9; 95% CI, 0.4–2.1) among participants of all ages. However, in persons aged less than 70 years, baseline RVO was associated with higher cardiovascular mortality (combined BDES and BMES: HR, 2.5; 95% CI, 1.2–5.2; BDES: HR, 2.5; 95% CI, 0.9–6.9; BMES: HR, 2.1; 95% CI, 0.7–6.8).
Conclusions
Retinal vein occlusion in persons aged 43 to 69 years may signal a doubling of the risk of cardiovascular mortality.
1Centre for Vision Research, Department of Ophthalmology, Westmead Millennium Institute, University of Sydney, Sydney, Australia.
2Department of Ophthalmology & Visual Sciences, University of Wisconsin Medical School, Madison, Wisconsin.
3Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia.
4Singapore Eye Research Institute, National University of Singapore, Singapore.
Correspondence to Jie Jin Wang, MMed, PhD, Centre for Vision Research, Department of Ophthalmology, Westmead Millennium Institute, University of Sydney, Westmead Hospital, Hawkesbury Road, Westmead, New South Wales, Australia 2145.
Manuscript no. 2006-263.
Supported by the Australian National Health & Medical Research Council, Canberra, Australia (grant nos.: 153948, 302068, 974159, 211069); National Institutes of Health, Bethesda, Maryland (grant no.: EY 06594 [RK, BEKK]); and Research to Prevent Blindness, Inc., New York, New York (RK, BEKK).
ABSTRACT