Cardiovascular morbidity and all-cause mortality in patients with retinal vein occlusion: a Danish nationwide cohort study

Background/aims Associations between retinal vein occlusion (RVO) and subsequent cardiovascular disease (CVD) or mortality have not been evaluated in a recent cohort, after novel therapeutic options have increased referrals for treatment of the condition. We aimed to evaluate overall and subtype-stratified risk of CVD and all-cause mortality following RVO and assess any alterations after the introduction of angiostatic therapy in Denmark in 2011. Methods This nationwide, registry-based cohort study from 1998 to 2018 evaluated 4 194 781 individuals. Hazard ratios (HRs) were reported for RVO as an overall measure and subclassified as branch and central RVO. Results Patients with RVO (n=15 665) were median 71.8 years old at the time of exposure and 50.7% were women. RVO associated with incident CVD (adjusted HR 1.13, 95% CI 1.09 to 1.17) but not mortality (adjusted HR 1.01, 95% CI 0.98 to 1.03). Almost similar risks of CVD were found for patients with branch and central RVO (adjusted HRs 1.14, 95% CI 1.03 to 1.25, and 1.12, 95% CI 1.00 to 1.25, respectively), but only patients with central RVO exhibited increased mortality (adjusted HR 1.18, 95% CI 1.11 to 1.26). Mortality was higher for patients diagnosed after 2011 (adjusted HRs 1.11, 95% CI 1.06 to 1.16 vs 0.97, 95% CI 0.94 to 1.00). Conclusion In a cohort of the Danish population aged 40 years or more, patients with RVO had a 13% increased risk of incident CVD compared with unexposed individuals. Mortality was increased after 2011, when intravitreal angiostatic treatment was introduced and referral practices altered.

Automated summary

In a Danish study, it was found that patients with retinal vein occlusion (RVO) had a 13% increased risk of cardiovascular disease (CVD), but no increased risk of mortality. Similar risks of CVD were observed for branch and central RVO, but only central RVO patients exhibited increased mortality. Mortality was further increased after the introduction of angiostatic therapy and altered referral practices in 2011.