Abstract
Background
A characteristic of the retinal circulation is that arterial occlusion is embolic
or secondary to vasculitis but rarely or never due to in situ atherosclerosis. Therefore,
retinal artery occlusion suggests the presence of cardiac or large-vessel disease
outside the eye. This cohort study examined the general risk of macrovascular disease
in individuals with diabetes, with or without retinal artery occlusion.
Methods
We retrieved data on 992 subjects with incident retinal artery occlusion and preexisting
diabetes, registered in Denmark between January 1, 2000, and December 31, 2018. Each
retinal artery occlusion subject was matched for age, sex, and diabetes duration,
with 5 control subjects with diabetes but without retinal artery occlusion. We performed
survival analyses to compare the risk of extraocular macrovascular disease between
the 2 groups in a 5-year follow-up.
Results
After 1 year, the incidence of macrovascular disease in subjects with retinal artery
occlusion was approximately 21 per 100 person-years (95% confidence interval [CI]:
18.11-24.29), compared to 6.25 per 100 patient-years (95% CI: 5.57-7.00) in those
without retinal artery occlusion. After 5 years, the cumulative incidences of macrovascular
disease were 51.2% (95% CI: 47.9-54.7%) and 29.4% (95% CI: 28.0-30.8%) in patients
with diabetes with or without retinal artery occlusion, respectively. Hazard rate
ratios were 3.36 (95% CI: 2.79-4.05) after 1 year and 2.27 (95% CI: 2.04-2.53) after
5 years.
Conclusion
Among individuals with diabetes, those diagnosed with retinal artery occlusion had
a higher general risk of macrovascular complications for at least 5 years after the
occlusion event compared with those without retinal artery occlusion.
Keywords
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Article info
Publication history
Published online: September 25, 2022
Footnotes
Funding: This study was partly funded by an unrestricted grant from the Obel Family Foundation and Lions Club Bannerslund. The sponsor did not influence the design or execution of the study.
Conflicts of Interest: MO reports none. HV has served as an advisory board member for Bayer and Novartis. TBL has been an investigator for Janssen Scientific Affairs, LLC, Bayer AG, and Boehringer Ingelheim and has also received speaker honoraria from Bayer, Bristol-Myers Squibb, Pfizer, and Merck Sharp & Dome. ML is a principal investigator on trials at the Rigshospitalet sponsored by Novartis, Allergan, Alcon, Novo Nordisk, Eli Lilly, Spark Therapeutics, Nightstar, Sanofi and Roche and has been compensated for speaking and consulting for several of these entities. FLS has received consultancy fees from Bayer.
Authorship: All authors had access to the data and a role in writing this manuscript.
Identification
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