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Correlation of the history of stroke and the retinal artery occlusion: a nested case-control study
Yue-Yan Xiao1, Wen-Bin Wei1, Ya-Xing Wang1
1Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
Insights
A history of stroke significantly increases the risk of retinal artery occlusion (RAO). Carotid artery plaques are also linked to RAO, indicating a need for comprehensive vascular risk management.
Area of Science:
- Ophthalmology
- Neurology
- Vascular Medicine
Background:
- Retinal artery occlusion (RAO) is a serious condition affecting vision.
- Systemic factors contributing to RAO require further investigation.
- Understanding these factors can aid in prevention and management strategies.
Purpose of the Study:
- To investigate systemic factors, particularly stroke history, associated with retinal artery occlusion (RAO).
- To identify key risk factors for RAO using a case-control study design.
Main Methods:
- A retrospective nested case-control study was conducted using data from the Kailuan Study cohort.
- 45 patients diagnosed with RAO (case group) were matched with 225 controls.
- Conditional multivariate logistic regression analysis was employed to identify risk factors.
Main Results:
- A history of stroke was significantly associated with an increased incidence of RAO (OR=28.794, P=0.0023).
- Cranial CT scans revealed infarctions or malacia in 81.6% of RAO patients, primarily in the basal ganglia and centrum semiovale.
- Carotid artery plaques were present in 88.9% of RAO cases.
Conclusions:
- A history of stroke is a significant predictor of RAO.
- The presence of carotid artery plaques, rather than severe stenosis, appears more indicative of RAO risk.
- These findings highlight the importance of managing cerebrovascular health to prevent RAO.
Aim:
To analyze the systemic factors including stroke history related to the retinal artery occlusion (RAO).
Methods:
Patients with an exact diagnosis of RAO in the medical database of the Kailuan Corporation were identified as the case group. Five patients without RAO were added for each case from the Kailuan Study and matched for sex and age (age±2) as the control group. The Kailuan Study is a general population-based cohort study in northern China, in which a total of 101 510 individuals (81 110 men) aged 18-98y were recruited to participate in the study. And the participants were bi-annually re-examined. The database of both groups was from Kailuan study of 2010 cohort. All the information, including the demographic characteristics, lifestyle behaviors, medical comorbidities, medical history, family medical history, drug usage, anthropometric measurements, blood pressure measurement, blood sample laboratory assessment, urine tests, and other physical examinations were all collected. A retrospective nested case-control method was used for this study. Conditional multivariate logistic regression was used to analyze the risk factors with SPSS 13.0 software and SAS 9.3 software.
Results:
A total of 45 patients were included as the case group, and the control group included 225 patients. In the case group, 28 patients (62.2%) had a central retinal artery occlusion (CRAO), and 17 patients (37.8%) had a branch retinal artery occlusion (BRAO). A total of 18 patients (40.0%) had a stroke before the RAO (mean 4.04±3.88y before the RAO), and 31 patients (81.6%) had infarctions or malacia identified by the cranial computed tomography (CT) scans. The basal ganglia and centrum semiovale were the most frequently involved regions. Plaques in the common carotid artery were present in 32 patients (88.9%). Conditional multivariate logistic regression analysis showed that the RAO was found to be associated with the history of stroke (P=0.0023, OR=28.794; 95%CI: 3.322-249.586).
Conclusion:
A history of stroke can significantly increase the incidence of RAO. Exists of plaque in the carotid artery is mean more than its severe stenosis for RAO.
