Mortality in patients with branch retinal vein occlusion

Purpose: To assess the impact of branch retinal vein occlusion (BRVO), a condition related to arteriolar wall thickening, as a prognostic marker of mortality. Design: Long-term follow-up study comparing cases with background population. Participants: Patients diagnosed with BRVO. Methods: Diagnosis of BRVO confirmed by fundus photographic records including color diapositives and fluorescein angiograms. Main Outcome Measures: Observed and expected numbers of deaths determined from comprehensive civic records in cases compared with the background population (5.4 million). Results: Branch retinal vein occlusion was found in 329 patients (173 women, 156 men) born between 1902 and 1956, who were 39 to 91 years old when diagnosed between 1973 and 1998. Follow-up was concluded on July 8, 2004, when 144 deaths were recorded in patients (74 women, 70 men), compared with an expected number of 145.5 deaths in the background population (standardized mortality rate, 0.99; 95% confidence interval, 0.84-1.16). Stratified analyses revealed no significant effect of age, gender, or time of diagnosis. Conclusions: In this study of 329 patients with BRVO, we found no significant difference in mortality between patients and the background population. An association between BRVO and cardiovascular/cerebrovascular risk factors has previously been documented in cross-sectional studies. The contrasting outcome in this longitudinal study may have been influenced by interventions instituted after the diagnosis of BRVO was made and by preferential survival before the diagnosis of BRVO of the more fit patients with the necessary precursor condition of having arteriovenous nicking, which is more prevalent in subjects with diabetes and hypertension.