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Medical conditions underlying retinal vein occlusion in patients with glaucoma or ocular hypertension
M D Cole1, P M Dodson, S Hendeles
1Birmingham and Midland Eye Hospital.
Insights
Glaucoma and ocular hypertension do not significantly increase retinal vein occlusion risk. Underlying medical conditions like systemic hypertension and hyperlipidaemia are more critical factors, necessitating comprehensive medical evaluations for patients with retinal vein occlusion.
Area of Science:
- Ophthalmology
- Vascular Medicine
- Public Health
Background:
- Retinal vein occlusion (RVO) is a significant cause of vision loss.
- The role of glaucoma and ocular hypertension (OHT) as etiological factors in RVO is not fully understood.
- Systemic vascular risk factors are known contributors to RVO.
Purpose of the Study:
- To investigate the prevalence of systemic hypertension and hyperlipidaemia in patients with RVO and co-existing glaucoma or OHT.
- To compare these prevalence rates with a control group of RVO patients without glaucoma or OHT.
- To assess the etiological contribution of glaucoma/OHT versus systemic medical conditions in RVO development.
Main Methods:
- Retrospective medical assessment of patients with RVO, categorized by the presence or absence of glaucoma/OHT.
- Comparison with an age- and sex-matched control group.
- Analysis of systemic hypertension and hyperlipidaemia prevalence across groups.
Main Results:
- No statistically significant differences in systemic hypertension or hyperlipidaemia prevalence were found between RVO patients with and without glaucoma/OHT.
- Prevalence of systemic hypertension (60.5%) and hyperlipidaemia (38.1%) in glaucoma patients with RVO.
- Prevalence of systemic hypertension (66.6%) and hyperlipidaemia (37.5%) in OHT patients with RVO.
- High prevalence of systemic hypertension (89%) and hyperlipidaemia (55.5%) noted in patients with recurrent RVO, irrespective of glaucoma status.
Conclusions:
- Glaucoma and ocular hypertension appear to play a less prominent etiological role in retinal vein occlusion compared to underlying systemic medical conditions.
- Systemic hypertension and hyperlipidaemia are significant risk factors for retinal vein occlusion, particularly in recurrent cases.
- Comprehensive medical assessment is crucial for all patients presenting with retinal vein occlusion.
Abstract:
Forty-three patients with glaucoma and 24 patients with ocular hypertension presenting with a retinal vein occlusion were medically assessed. The prevalence of systemic hypertension was 60.5% in those with glaucoma and 66.6% with ocular hypertension. The prevalence of hyperlipidaemia was 38.1% in those with glaucoma and 37.5% in those with ocular hypertension. These findings were compared with those from a carefully age-sex matched group of patients presenting with a retinal vein occlusion without evidence of glaucoma or ocular hypertension. There were no statistical differences between any of the groups (52.2% had systemic hypertension and 28.8% had hyperlipidaemia). There was also a strikingly high prevalence of systemic hypertension (89%) and hyperlipidaemia (55.5%) in nine of the patients who had evidence of a recurrent retinal vein occlusion associated with glaucoma, and these prevalence rates were strikingly similar to the rates in patients with recurrence but without glaucoma. The data suggest that glaucoma or ocular hypertension has a less prominent aetiological role in the development of a retinal vein occlusion than underlying medical causes and that full medical assessment is worthwhile.