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Traditional and Novel Cardiovascular Risk Factors for Retinal Vein Occlusion: The Multiethnic Study of Atherosclerosis

¹From the Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, East Melbourne, Victoria, Australia; the ²Department of Ophthalmology and Visual Science, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; the ³Division of Epidemiology and Clinical Research, National Eye Institute, National Institutes of Health, Bethesda, Maryland; the ⁴Departments of Medicine and ⁵Pathology, University of Vermont, Burlington, Vermont; and the ⁶Singapore Eye Research Institute, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

PURPOSE. To describe the prevalence of retinal vein occlusion (RVO) and its association with cardiovascular, inflammatory, and hematologic risk factors in a multiethnic cohort.

METHODS. This was a population-based, cross-sectional study of 6147 participants (whites, blacks, Hispanics, Chinese) from six U.S. communities. RVO was defined from retinal photographs taken from both eyes according to a standardized protocol. Risk factors were assessed from interviews, examinations, and laboratory and radiologic investigations.

RESULTS. The prevalence of RVO was 1.1% (0.9% for branch RVO and 0.2% for central RVO) and was similar across different ethnic groups: 0.9% in whites, 1.2% in blacks, 1.2% in Hispanics, and 1.1% in Chinese (P = 0.76). Independent risk factors associated with RVO were hypertension (odds ratio [OR], 2.06; 95% confidence interval [CI], 1.18–3.59), older age (OR, 1.34; 95% CI, 1.00–1.81, per decade increase), less education (OR, 4.08; 95% CI, 2.20–7.54), hypertriglyceridemia (OR, 1.98; 95% CI, 1.10–3.56), renal dysfunction (OR, 1.85; 95% CI, 1.01–3.39), and the presence of retinal arteriovenous nicking (OR, 4.01; 95% CI, 2.06–7.81) and focal arteriolar narrowing (OR, 4.38; 95% CI, 1.44–13.34). RVO was not significantly associated with direct measures of subclinical atherosclerosis (e.g., carotid intima media thickness and coronary artery calcium scores) or markers of inflammation (e.g., C reactive protein, interleukin-6) and endothelial dysfunction (e.g., soluble intercellular adhesion molecule-1) or coagulation (e.g., D-dimer).

CONCLUSIONS. The prevalence of RVO is similar across different racial/ethnic groups. In the general population, RVO is associated with hypertension, dyslipidemia, and renal dysfunction, but not with atherosclerotic disease, systemic inflammation, and hematologic abnormalities.