SYSTEMIC THROMBOEMBOLIC OUTCOMES IN YOUNG PATIENTS AFTER RETINAL VEIN OCCLUSIONS

To evaluate the long-term incidence of hypercoagulable complications in young patients with retinal vein occlusions and negative workups compared with matched controls.

A retrospective cohort study was conducted using the TriNetX Analytics Network. Patients aged 18 to 50 with newly diagnosed retinal vein occlusion and no history of hypertension, glaucoma, thrombophilia, or recent oral contraceptive use were compared with age-matched controls. Propensity score matching was performed to balance baseline demographics and comorbidities. Primary outcomes included the cumulative incidence and risk ratio (RR) of deep vein thrombosis, pulmonary embolism, cerebral infarction, anticoagulant use, composite embolic events, myocardial infarctions and composite cardiovascular events over 1, 3, and 5 years. A secondary validation cohort was performed using controls diagnosed with astigmatism.

After propensity score matching, 2,731 patients were included in each cohort. Patients with retinal vein occlusion had significantly higher rates of venous thromboembolism, cerebral infarction, anticoagulation use, and composite embolic outcomes at 1, 3, and 5 years (all P < 0.0001). No significant differences were observed in myocardial infarctions or composite cardiovascular event outcomes.

Young patients with retinal vein occlusion and no identifiable vascular or hypercoagulable risk factors are at significantly increased risk for venous thrombosis and stroke, but not myocardial infarction.