Cardiovascular risk factors for retinal vein occlusion and arteriolar emboli: The atherosclerosis risk in communities & cardiovascular health studies

Tien Yin Wong, Emily K.Marino Larsen, Ronald Klein, Paul Mitchell, David J. Couper, Barbara E.K. Klein, Larry D. Hubbard, David S. Siscovick, A. Richey Sharrett

Research output: Contribution to journalArticle

Abstract

Objective: To examine the associations of retinal vein occlusion and arteriolar emboli with cardiovascular disease. Design: Population-based cross-sectional study. Participants: Pooled from the Atherosclerosis Risk in Communities Study (n = 12 642; mean age, 60 years) and the Cardiovascular Health Study (n = 2824; mean age, 79 years). Methods: Retinal vein occlusion and arteriolar emboli were identified from a single nonmydriatic retinal photograph using a standardized protocol. Photographs were also graded for arteriovenous nicking and focal arteriolar narrowing. All participants had a comprehensive systemic evaluation, including standardized carotid ultrasonography. Main Outcome Measures: Retinal vein occlusion and arteriolar emboli. Results: Prevalences of retinal vein occlusion and arteriolar emboli were 0.3% (n = 39 cases) and 0.2% (n = 34 cases), respectively. After adjusting for age, retinal vein occlusion was associated with hypertension (odds ratio [OR], 2.96; 95% confidence interval [CI], 1.43-6.14), systolic blood pressure (BP) (OR, 4.12; 95% CI, 1.40-12.16; highest quartile vs. lowest), diastolic BP (OR, 2.64; 95% CI, 1.07-6.46; highest quartile vs. lowest), carotid artery plaque (OR, 5.62; 95% CI, 2.60-12.16), body mass index (OR, 3.88; 95% CI, 1.23-12.18; highest quartile vs. lowest), plasma fibrinogen (OR, 3.29; 95% CI, 1.08-10.02; highest quartile vs. lowest), arteriovenous nicking (OR, 4.09; 95% CI, 2.00-8.36), and focal arteriolar narrowing (OR, 5.17; 95% CI, 2.59-10.29). After adjusting for age, retinal arteriolar emboli were associated with hypertension (OR, 3.14; 95% CI, 1.44-6.84), systolic BP (OR, 3.46; 95% CI, 1.13-10.65; highest quartile vs. lowest), prevalent coronary heart disease (OR, 2.33; 95% CI, 1.01-5.42), carotid artery plaque (OR, 4.62; 95% CI, 1.85-11.57), plasma lipoprotein (a) (OR, 3.69; 95% CI, 1.20-11.41; highest quartile vs. lowest), plasma fibrinogen (OR, 3.09; 95% CI, 0.98-9.76; highest quartile vs. lowest), and current cigarette smoking (OR, 3.08; 95% CI, 1.47-6.47). Approximately a quarter of participants with retinal vein occlusion and arteriolar emboli had evidence of carotid artery plaque as defined from ultrasound. Conclusions: Retinal vein occlusion and retinal arteriolar emboli are associated with carotid artery disease, hypertension, and other cardiovascular risk factors.

Original languageEnglish (US)
Pages (from-to)540-547
Number of pages8
JournalOphthalmology
Volume112
Issue number4
DOIs
StatePublished - Apr 1 2005

ASJC Scopus subject areas

  • Ophthalmology

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    Wong, T. Y., Larsen, E. K. M., Klein, R., Mitchell, P., Couper, D. J., Klein, B. E. K., Hubbard, L. D., Siscovick, D. S., & Sharrett, A. R. (2005). Cardiovascular risk factors for retinal vein occlusion and arteriolar emboli: The atherosclerosis risk in communities & cardiovascular health studies. Ophthalmology, 112(4), 540-547. https://doi.org/10.1016/j.ophtha.2004.10.039