Cardiovascular risk factors for retinal vein occlusion and arteriolar emboli: the Atherosclerosis Risk in Communities & Cardiovascular Health studies.
OBJECTIVE
To examine the associations of retinal vein occlusion and arteriolar emboli with cardiovascular disease.


METHODS
Population-based cross-sectional study.


METHODS
Pooled from the Atherosclerosis Risk in Communities Study (n = 12,642; mean age, 60 years) and the Cardiovascular Health Study (n = 2824; mean age, 79 years).


METHODS
Retinal vein occlusion and arteriolar emboli were identified from a single nonmydriatic retinal photograph using a standardized protocol. Photographs were also graded for arteriovenous nicking and focal arteriolar narrowing. All participants had a comprehensive systemic evaluation, including standardized carotid ultrasonography.


METHODS
Retinal vein occlusion and arteriolar emboli.


RESULTS
Prevalences of retinal vein occlusion and arteriolar emboli were 0.3% (n = 39 cases) and 0.2% (n = 34 cases), respectively. After adjusting for age, retinal vein occlusion was associated with hypertension (odds ratio [OR], 2.96; 95% confidence interval [CI], 1.43-6.14), systolic blood pressure (BP) (OR, 4.12; 95% CI, 1.40-12.16; highest quartile vs. lowest), diastolic BP (OR, 2.64; 95% CI, 1.07-6.46; highest quartile vs. lowest), carotid artery plaque (OR, 5.62; 95% CI, 2.60-12.16), body mass index (OR, 3.88; 95% CI, 1.23-12.18; highest quartile vs. lowest), plasma fibrinogen (OR, 3.29; 95% CI, 1.08-10.02; highest quartile vs. lowest), arteriovenous nicking (OR, 4.09; 95% CI, 2.00-8.36), and focal arteriolar narrowing (OR, 5.17; 95% CI, 2.59-10.29). After adjusting for age, retinal arteriolar emboli were associated with hypertension (OR, 3.14; 95% CI, 1.44-6.84), systolic BP (OR, 3.46; 95% CI, 1.13-10.65; highest quartile vs. lowest), prevalent coronary heart disease (OR, 2.33; 95% CI, 1.01-5.42), carotid artery plaque (OR, 4.62; 95% CI, 1.85-11.57), plasma lipoprotein (a) (OR, 3.69; 95% CI, 1.20-11.41; highest quartile vs. lowest), plasma fibrinogen (OR, 3.09; 95% CI, 0.98-9.76; highest quartile vs. lowest), and current cigarette smoking (OR, 3.08; 95% CI, 1.47-6.47). Approximately a quarter of participants with retinal vein occlusion and arteriolar emboli had evidence of carotid artery plaque as defined from ultrasound.


CONCLUSIONS
Retinal vein occlusion and retinal arteriolar emboli are associated with carotid artery disease, hypertension, and other cardiovascular risk factors.
Wong
Tien Yin
TY
Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia. ophwty@nus.edu.sg
Larsen
Emily K Marino
EK
Klein
Ronald
R
Mitchell
Paul
P
Couper
David J
DJ
Klein
Barbara E K
BE
Hubbard
Larry D
LD
Siscovick
David S
DS
Sharrett
A Richey
AR
D000368:Aged; D000369:Aged, 80 and over; D001160:Arterioles; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000209:etiology; D016893:Carotid Stenosis / Q000209:etiology*; D003324:Coronary Artery Disease / Q000209:etiology*; D003430:Cross-Sectional Studies; D004617:Embolism / Q000150:complications*; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D006801:Humans; D006973:Hypertension / Q000209:etiology*; D017270:Lipoprotein(a) / Q000032:analysis; D008297:Male; D015201:Meta-Analysis as Topic; D008875:Middle Aged; D012161:Retinal Artery / Q000473:pathology*; D012170:Retinal Vein Occlusion / Q000150:complications*; D012307:Risk Factors
D017270:Lipoprotein(a); D005340:Fibrinogen