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Retinal Artery Occlusion and the Risk of Stroke Development: Twelve-Year Nationwide Cohort Study
Tyler Hyungtaek Rim1, Jinu Han1, Yoon Seong Choi1
1From the Department of Ophthalmology, Severance Hospital, Institute of Vision Research (T.H.R., J.H., C.S.L., S.C.L., S.S.K.), Department of Radiology, Severance Hospital (Y.S.C.), and Yonsei Healthcare Big Data Based Knowledge Integration System Research Center and Institute of Convergence Science (S.S.K.), Yonsei University College of Medicine, Seoul, Korea; and Department of Social and Preventive Medicine, Inha University School of Medicine, Epidemiology, Incheon, South Korea (S.-s.H.).
Insights
Retinal artery occlusion (RAO) significantly increases stroke risk, particularly in younger adults. This study highlights the importance of monitoring patients post-RAO for subsequent stroke development.
Area of Science:
- Ophthalmology
- Neurology
- Public Health
Background:
- Retinal artery occlusion (RAO) is a critical condition affecting vision.
- Understanding the long-term risks following RAO, such as stroke, is crucial for patient management.
Purpose of the Study:
- To evaluate the risk of subsequent stroke development in patients who have experienced retinal artery occlusion (RAO).
Main Methods:
- Utilized Korean National Health Insurance Service registry data from 2004-2013.
- Included 401 patients diagnosed with RAO and 2003 matched controls.
- Employed Cox proportional hazard regression analysis to assess stroke risk.
Main Results:
- Patients with RAO had a significantly higher incidence of stroke (15.0% vs. 8.0%).
- RAO was associated with a 1.78-fold increased risk of stroke.
- The stroke risk associated with RAO was more pronounced in adults under 65, but older adults (≥65) showed a significant increased risk at 4-year follow-up.
Conclusions:
- Retinal artery occlusion is a significant independent risk factor for subsequent stroke.
- Findings suggest a need for vigilant stroke risk assessment in RAO patients.
- Further observational studies are warranted to confirm these associations due to potential confounding factors.
Background And Purpose:
Our aim was to evaluate the risk of subsequent stroke development after retinal artery occlusion (RAO).
Methods:
National registry data were collected from the Korean National Health Insurance Service, comprised 1 025 340 random subjects. Patients diagnosed with RAO in 2002 and 2003 were excluded. The RAO group was composed of patients with an initial diagnosis of either central or other RAO between January 2004 and December 2013 (n=401). The comparison group was composed of randomly selected patients (5 per RAO patient; n=2003) who were matched to the RAO group according to sociodemographic factors and year of RAO diagnosis. Each sampled patient was tracked until 2013. Cox proportional hazard regression was used.
Results:
Stroke occurred in 15.0% of the RAO group and in 8.0% of the comparison group (P < 0.001). RAO was associated with an increased risk of stroke occurrence (hazard ratio, 1.78; 95% confidence interval, 1.32-2.41). The magnitude of the RAO effect for stroke was larger among younger adults aged <65 years (hazard ratio, 3.11) than older adults aged ≥65 years (hazard ratio, 1.26). However, the risk of subsequent stroke was significantly increased in older adults aged ≥65 years at the 4-year follow-up (hazard ratio, 1.58; 95% confidence interval, 1.01-2.48).
Conclusions:
RAO was significantly associated with subsequent stroke after adjusting for comorbidities and sociodemographic factors. These findings are limited by uncontrolled confounding factors and need to be replicated by other observational studies.
