The association between retinal vascular occlusions and dementia using TriNetX

BackgroundRetinal vascular occlusions have been associated with higher incidence of dementia and may serve as clinical indicators for underlying cognitive disease.ObjectiveThis study investigated whether retinal vascular occlusion and their subtypes are linked to increased risk of dementia, including all-cause dementia, Alzheimer's disease (AD), and vascular dementia (VaD).MethodsParticipants age 65 and over were categorized into eight groups using the TriNetX global database: 1) Retinal vascular occlusion, 2) Retinal artery occlusions (RAO), 3) Retinal vein occlusions (RVO), 4) Central retinal artery occlusions (CRAO), 5) Branch retinal artery occlusions (BRAO), 6) Central retinal vein occlusions (CRVO), 7) Branch retinal vein occlusions (BRVO), and 8) No retinal vascular occlusions. Groups were propensity score matched 1:1 for demographic and clinical covariates. Outcomes include the risk of all-cause dementia, AD, and VaD, assessed using Cox proportional hazard ratios with 95% confidence intervals. Kaplan-Meier analysis evaluated time to dementia onset.ResultsThe TriNetX database identified 21,367 individuals with retinal vascular occlusion who were followed for an average of 6.29 years. Participants with retinal vascular occlusions, RVOs, or BRVOs demonstrated higher risk of all-cause dementia and VaD. There were no increased associations for retinal vascular occlusions and AD.ConclusionsRetinal vascular occlusions and RVOs were associated with an increased risk of all-cause dementia and VaD, but not AD. No associations were found with RAOs. Retinal vein occlusions may serve as a potential clinical marker for underlying neurodegenerative disease and emphasize the need for careful monitoring in patients with retinal vascular occlusions.