Retinal Artery Occlusion and the Risk of Stroke Development

Abstract

Background and Purpose— Our aim was to evaluate the risk of subsequent stroke development after retinal artery occlusion (RAO). Methods— National registry data were collected from the Korean National Health Insurance Service, comprised 1 025 340 random subjects. Patients diagnosed with RAO in 2002 and 2003 were excluded. The RAO group was composed of patients with an initial diagnosis of either central or other RAO between January 2004 and December 2013 (n=401). The comparison group was composed of randomly selected patients (5 per RAO patient; n=2003) who were matched to the RAO group according to sociodemographic factors and year of RAO diagnosis. Each sampled patient was tracked until 2013. Cox proportional hazard regression was used. Results— Stroke occurred in 15.0% of the RAO group and in 8.0% of the comparison group ( P < 0.001). RAO was associated with an increased risk of stroke occurrence (hazard ratio, 1.78; 95% confidence interval, 1.32–2.41). The magnitude of the RAO effect for stroke was larger among younger adults aged <65 years (hazard ratio, 3.11) than older adults aged ≥65 years (hazard ratio, 1.26). However, the risk of subsequent stroke was significantly increased in older adults aged ≥65 years at the 4-year follow-up (hazard ratio, 1.58; 95% confidence interval, 1.01–2.48). Conclusions— RAO was significantly associated with subsequent stroke after adjusting for comorbidities and sociodemographic factors. These findings are limited by uncontrolled confounding factors and need to be replicated by other observational studies.

Perioperative Retinal Artery Occlusion

“…Vasculitis also is associated with RAO, 29,33 including giant cell arteritis, which had the highest OR among all RAO risk factors in the present study. Giant cell arteritis has been implicated in ocular syndromes, including blindness, 28 and is often accompanied by other vascular diseases; thus, it may be a marker for vascular disease.…”

“…12,31,32 Hospital conditions included anemia, transfusion, cardiogenic shock, and postoperative bleeding. Stroke was included as embolic, thrombotic, transient ischemia, and “other.” 33 …”

Impact of metabolic status on the incidence of psoriasis: a Korean nationwide cohort study

“…The NHIS then established the nationwide National Sample Cohort (NHIS-NSC)—a database that provides public health information, such as the participants’ medical bill expenses claimed by medical service providers. A total of 1,025,340 nationally representative subjects were randomly selected from the Korean population in 2002, which amounts to ~2.2% of the population, and were followed until 2013 11 . Proportionate stratified random sampling was conducted based on a total of 1476 strata.…”

Central Retinal Artery Occlusion: Acute Management and Treatment

“…Analysis from the Korean National Health Insurance claims data indicated that patients with CRAO carry a 1.78 fold increased risk (95% confidence interval, 1.32 – 2.41) of development of cerebral stroke within 4 years when compared to a cohort of age-matched controls. 5 A 2016 review of retrospective cohort-control comparison studies (324,518 total cases) indicated that patients presenting with retinal artery occlusion had a higher lifetime development of cerebrovascular disease including myocardial infarction and stroke (odds ratio of 2.01; 95% confidence interval: 1.21–3.34). 6 In fact, 23–24% of patients with acute retinal ischemia have MRI evidence of concurrent silent cerebral infarctions, as seen in three retrospective studies of a combined 375 patients who were imaged with diffusion-weighted MRI at time of visual loss.…”