Retinal artery occlusion and the 3-year risk of stroke in Taiwan: a nationwide population-based study.
OBJECTIVE
To verify the association between retinal artery occlusion (RAO) and stroke with a large-scale nationwide study.


METHODS
Retrospective nationwide population-based administrative database study.


METHODS
Data were collected from the Longitudinal Health Insurance Database 2000 (LHID2000), which contains claim data from 1 million randomly selected beneficiaries among Taiwan's 23 million residents. The study cohort consisted of all patients with a diagnosis of RAO from January 1999 through December 2006 (n = 464). The control group consisted of randomly selected patients (n = 2748) matched with the study group by age, sex, date of index medical care, and comorbid hypertension. Patients were tracked from their index date for 3 years. The Kaplan-Meier method was used to compute the stroke-free survival rate. Cox proportional hazard regressions were used to compute the adjusted stroke-free survival rate after adjusting for possible confounding factors.


RESULTS
Ninety-one RAO patients (19.61%) and 280 controls (10.05%) had a stroke (P < .0001) during the 3-year follow-up period. Compared with the controls, the incidence rate ratios of stroke in RAO patients were 9.46 at 0-1 month, 5.57 at 1-6 months, and 2.16 at 0-3 years after RAO (P < .0001). After adjusting for age, sex, and selected comorbid disorders, the hazard ratio of having a stroke for RAO patients was still 2.07 times higher than that of controls and 3.34 times higher in the ≤60-year-old subgroup.


CONCLUSIONS
RAO increases the risk for subsequent stroke. Early neurologic evaluation and secondary prevention for stroke are recommended for RAO patients.
Department of Ophthalmology, Chi Mei Medical Center, Tainan, Taiwan.
Yuh-Shin
YS
Chang
Ren-Long
RL
Jan
Shih-Feng
SF
Weng
Jhi-Joung
JJ
Wang
Chung-Ching
CC
Chio
Fu-Tsung
FT
Wei
Chin-Chen
CC
Chu
D000368:Aged; D016022:Case-Control Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000706:statistics & numerical data; D016016:Proportional Hazards Models; D015356:Retinal Artery Occlusion / Q000175:diagnosis / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology*; D015996:Survival Rate; D013624:Taiwan / Q000453:epidemiology