Association between Statins and Retinal Vascular Occlusion: A Population-Based Cohort Study

Chien, Chien-Cheng; Chen, Po-Huang; Chung, Chi‐Hsiang; Sun, Chien‐An; Chien, Wu-Chien; Chien, Ke‐Hung

doi:10.3390/ijerph18189864

Cited by 9 publications

(5 citation statements)

References 52 publications

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“…Retinal arterial occlusion has been previously reported after vaccination with the mRNA COVID-19 vaccine, and were characterized by non-embolic, not accompanied by carotid plague or stenosis, rapid development within 2 weeks after vaccination, and without marked abnormalities of laboratory tests (such as increased D-dimer and C-reactive protein) [7]. The mean age of patients diagnosed with retinal vascular occlusion in the present study was 53 years, which was comparable to that of patients diagnosed with retinal vascular occlusion not associated with vaccination (53 years old) [25].…”

Section: Discussionsupporting

confidence: 53%

Ocular Adverse Events after Inactivated COVID-19 Vaccination

et al. 2022

Vaccines

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Purpose: To report the clinical characteristics of ocular adverse events that have occurred, in China, after vaccination with inactivated COVID-19 vaccines. Methods: A retrospective cross-sectional observational study was conducted of ocular disorders that occurred within 15 days from any dose of an inactivated COVID-19 vaccine. Information on gender, age, the interval between the vaccination and ocular symptoms, laterality, duration of the ocular symptoms, primary visual acuity, and clinical diagnosis were retrospectively collected. Results: Twenty-four patients were involved in the study, including 15 females and 9 males, with a mean age of 41 ± 16 years (range of 8–71 years). The patients all denied a prior history of COVID-19 infection. Ocular adverse events occurred after the first dose of vaccine in 18 patients and, after the second or third doses, in six patients. The interval between vaccination with the inactivated COVID-19 vaccine and ocular symptoms was 6 ± 5 days; six patients were bilaterally involved and 18 patients were unilaterally involved. Regarding the diagnosis, 10 patients were diagnosed with white dot syndrome (WDS), 9 patients were diagnosed with uveitis, and 5 patients were diagnosed with retinal vascular disorders. The ages of patients with WDS were younger than those with uveitis or retinal vascular disorders (32 ± 10 vs. 48 ± 18, p < 0.05). For patients diagnosed with WDS, the best-corrected visual acuity (BCVA) was 0.74 ± 0.73 LogMAR. For patients diagnosed with retinal vascular disorders or uveitis, the BCVA was 1.44 ± 1.26 LogMAR. There was no significant difference (p > 0.05). Conclusions: A relationship cannot be established between inactivated COVID-19 vaccines and ocular disorders; therefore, further investigation of the clinical spectrum of ocular adverse events after vaccination with an inactivated COVID-19 vaccine is necessary.

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Section: Discussionsupporting

confidence: 53%

Ocular Adverse Events after Inactivated COVID-19 Vaccination

et al. 2022

Vaccines

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“…In addition, many lipid trait SNPs carry metabolic syndrome trait effects, especially diabetes, which is an important and concerning confounder. A low HDL-C level is associated with a higher risk of type 2 diabetes ( 39 ) and studies have shown that RVO is associated with diabetes ( 40 ). After adjusting for diabetes, MVMR analysis demonstrates that low HDL-C may be an independent risk factor for RVO, suggesting that controlling of HDL-C level may be effective in managing RVO.…”

Section: Discussionmentioning

confidence: 99%

Plasma lipid levels and risk of retinal vascular occlusion: A genetic study using Mendelian randomization

et al. 2022

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The causal effects of plasma lipid levels and the risk of retinal vascular occlusion (RVO) have not been clearly identified, especially for high-density lipoprotein-cholesterol (HDL-C) and low-density lipoprotein-cholesterol (LDL-C). Here, we try to identify these causal risk factors using a two-sample Mendelian randomization (MR) analysis. Single nucleotide polymorphisms (SNPs) were chosen as instrumental variables (IVs). We obtained genetic variants associated with lipid exposure at the genome-wide significance (P<5×10−8) level from a meta-analysis of GWAS from the Global Lipids Genetics Consortium (GLGC) based on 188,577 individuals of mostly European ancestry for MR analyses. Meanwhile, we used lipid GWAS from UK Biobank (UKB) with a sample size of 115,078 individuals as a supplement. We obtained genetic predictors of RVO from a FinnGen biobank study. We conducted both univariable and multivariable MR (MVMR) analyses to identify the causal effects of RVO. Although inverse variance weighted (IVW) was the primary method used for MR analyses, MR–Egger and weighted-median methods were used as supplements to IVW. We determined the heterogeneity of IVs using Cochrane’s Q test and I2, and used the MR–Egger intercept and MR-PRESSO Global test to detect horizontal pleiotropy. A leave-one-out sensitivity analysis was conducted by removing a single variant from the analysis. Genetically predicted increased HDL-C level was associated with decreased risk of RVO from GLGC [OR=0.806; 95% CI=(0.659, 0.986); P=0.036], which was consistent with UKB results [OR=0.766; 95% CI=(0.635, 0.925); P=0.005]. MVMR analysis for plasma lipids [adjusted OR=0.639; 95% CI=(0.411, 0.992); P=0.046] or diabetes [adjusted OR=0.81; 95% CI=(0.67, 0.979); P=0.029] suggested that low HDL-C may be an independent risk factor for RVO. However, there was no evidence to support a causal association between LDL-C {GLGC [adjusted OR=1.015; 95% CI=(0.408, 2.523); P=0.975], UKB [OR=1.115; 95% CI=(0.884, 1.407); P=0.359]}, total cholesterol {GLGC [adjusted OR=0.904; 95% CI=(0.307, 2.659); P=0.854], UKB [OR=1.047; 95% CI=(0.816, 1.344); P=0.716]} or triglycerides {GLGC [OR=1.103; 95% CI=(0.883, 1.378); P=0.385], UKB [OR=1.003; 95% CI=(0.827, 1.217); P=0.098]} and RVO. Using two-sample MR analysis, our study suggested that dyslipidemia was a risk factor for RVO. Furthermore, our results indicated that a low HDL-C level may be an independent risk factor for RVO, suggesting that controlling HDL-C level may be effective in RVO development.

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“…16 Hyperlipidemia is a known risk factor for BRVO, and previous studies have found that statin therapy is associated with a decreased risk for BRVO. 17 Thus, the lower rate of statin use among older patients than among younger patients may have contributed to the increased proportion of older patients with hyperlipidemia in this study.…”

Section: Discussionmentioning

confidence: 83%

Acute, Treatment-Naïve Branch Retinal Vein Occlusion in Younger Individuals: Risk Factors and Clinical Outcomes

Kundu,

Thomas,

Mirzania

et al. 2023

Journal of VitreoRetinal Diseases

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Purpose: To compare the risk factors and clinical outcomes in patients younger than 50 years with acute, treatment-naïve branch retinal vein occlusion (BRVO) with outcomes in patients 50 years or older. Methods: Patients diagnosed with acute, treatment-naïve BRVO at Duke Eye Center over a 9.5-year period who had BRVO with onset 3 months or less before presentation, BRVO with macular involvement, and 12 months or more of follow-up were included. Demographic data, presenting clinical features, risk factors, treatment patterns, and clinical outcomes were extracted during a retrospective review of medical records. Results: Of 302 patients identified, 23 were younger than 50 years (younger group) and 279 were 50 years or older (older group). Compared with older patients, younger patients had similar rates of hypertension ( P = .275), diabetes mellitus ( P = 1.000), smokers ( P = .787), and open-angle glaucoma ( P = .628). The younger group had a lower rate of hyperlipidemia than the older group (35% vs 59%) ( P = .028). The 2 groups had similar presenting logMAR visual acuities (VAs) in the BRVO eye ( P = .131). At the final follow-up younger patients had significantly better logMAR VA in the BRVO-affected eye than older patients (mean 0.51 ± 0.65 vs 1.01 ± 1.20) ( P = .016). The 2 groups had similar treatment burdens at 1 year ( P = .516) and the final follow-up ( P = .782). Conclusions: Younger patients with acute, treatment-naïve BRVO have similar risk factors and treatment patterns as older patients, except for a lower rate of hyperlipidemia. Younger patients with BRVO may have similar presenting VA as older BRVO patients but better final VA, suggesting that age may be a potential prognostic factor.

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Association between Statins and Retinal Vascular Occlusion: A Population-Based Cohort Study

Cited by 9 publications

References 52 publications

Ocular Adverse Events after Inactivated COVID-19 Vaccination

Ocular Adverse Events after Inactivated COVID-19 Vaccination

Plasma lipid levels and risk of retinal vascular occlusion: A genetic study using Mendelian randomization

Acute, Treatment-Naïve Branch Retinal Vein Occlusion in Younger Individuals: Risk Factors and Clinical Outcomes

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