Patients after RAO at higher risk for death, vascular events
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Key takeaways:
- After retinal artery occlusion, patients are at a higher risk for death and vascular events.
- Multidisciplinary evaluation with long-term systemic follow-up is warranted.
Patients who experienced retinal artery occlusion are at higher risk for death, stroke and myocardial infarction in both the short and long term, according to a large retrospective cohort study.
Data were gathered from TriNetX, an electronic health records database including multiple large health care organizations in the U.S. and globally. A total of 34,552 patients with retinal artery occlusion (RAO) were identified and matched with a control group of patients with similar characteristics who were diagnosed with cataract. The primary outcome was rate of death, stroke or myocardial infarction (MI) at 2 weeks, 30 days, 1 year, 5 years and 10 years.
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The rate of death after RAO diagnosis was low in the short term: 0.14%, 0.29% and 3.51% at 2 weeks, 30 days and 1 year, respectively. However, the relative risk was double as compared with the cataract cohort. The risk for stroke was 1.72%, 2.48% and 5.89% at 2 weeks, 30 days and 1 year and was approximately 21-fold, 14-fold and fivefold higher than in the cataract group at the three time points. The risk for MI was 0.16%, 0.27% and 1.66% at 2 weeks, 30 days and 1 year and was threefold, 2.6-fold and 1.7-fold higher than in the cataract group, respectively.
In the 21,823 patients with a longer follow-up, the rate of death was higher in the RAO group than in the control group at 5 years (22.74% vs. 17.82%) but similar at 10 years (57.86% vs. 55.38%). There was an increased risk for stroke after RAO compared with the control cohort (10.86% vs. 4.86% at 5 years and 14.59% vs. 9.18% at 10 years) and also a slightly higher rate of MI (6.06% vs. 5% at 5 years and 10.55% vs. 9.43% at 10 years).
Male sex, hypertension, hyperlipidemia, diabetes and smoking were associated with an increased risk for vascular events.
“This highlights the importance of counseling for modifiable risk factors and optimizing a cardiovascular workup at the time of RAO,” the authors wrote, emphasizing “the potential need for multidisciplinary evaluation with long-term systemic follow-up of patients post-RAO.”
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