Detection of atrial fibrillation in patients with retinal vascular occlusions: a meta-analysis

The relationship between atrial fibrillation (AF) and retinal vascular occlusions has been inconsistently reported. Therefore, we conducted a systematic review and meta-analysis to evaluate the occurrence of AF in individuals with and without retinal vascular occlusions.

A thorough search of the PubMed database was conducted for relevant studies published from its inception through November 2023. Inclusion criteria were set for studies that reported on AF occurrence in patients with retinal vascular occlusions. The pooled effect sizes were determined using either a fixed-effects or random-effects model, as dictated by the I² statistic.

Our meta-analysis included 12 studies. In the meta-analysis, five studies (9418 retinal artery occlusion [RAO] patients and 26,116,452 controls) showed a significantly higher prevalence of AF in RAO patients (odds ratio [OR]=1.74, 95% confidence interval [CI] 1.15-2.63, P=0.009, I²=94%). Four studies (1622 retinal vein occlusion [RVO] patients and 92,910 controls) indicated a higher prevalence of AF in RVO patients (OR=2.28, 95% CI 1.93-2.69, P<0.00001, I²=0%). For follow-up incidence, two studies (806 RAO patients and 7840 controls) reported a higher rate of AF detection in RAO patients (hazard ratios [HR]=1.60, 95% CI 1.25-2.04, P=0.0002, I²=0%). Similarly, two studies (2330 RVO patients and 8641 RVO controls) revealed a higher rate of AF detection in RVO patients (HR=1.25, 95% CI 1.04-1.51, P=0.02, I²=49%).

Our evidence from this study suggests a significantly elevated prevalence and incidence of AF in patients with retinal vascular occlusions, indicating a potential association that warrants further investigation.