Abstract
Background: Retinopathy implied by microvascular dysfunction was known to be related to the risk of heart failure (HF) development. However, there have been no studies for evaluating the risk of HF following retinal vein occlusion (RVO), another surrogate ophthalmologic parameter for microvascular dysfunction. Methods: National registry data were collected from the Korean National Health Insurance Research Database, comprising 1,025,340 (2.2%) random subjects who were selected from 46,605,433 Korean residents in 2002. The definition of HF development based on diagnostic code. The RVO group was composed of patients with an initial diagnosis of either central or branch RVO between January 2003 and December 2007 (n=1,523). The comparison group was composed of randomly selected patients (five per RVO patient; n=7,620) who were matched to the RVO group according to age, gender, residential area, household income, and year of RVO diagnosis. Each sampled patient was tracked until 2013. Cox proportional hazard regressions were used to calculate the overall survival rate for HF development after adjusting for potential confounders, including hypertension, diabetes mellitus, and chronic kidney disease. Results: HF occurred in 11.6% of the RVO group and in 7.9% of the comparison group, respectively (p<0.001). RVO was significantly associated with an increased risk of HF development after adjusting for confounders (hazard ratio (HR) 1.36, 95% Confidence Interval (CI) 1.16-1.89, p<0.001). Other comorbidities including hypertension (HR=2.08), and chronic renal failure (HR=1.88) were also increased the risk of HF development. From the subgroup analysis by age or gender, RVO was still significantly associated with an increased risk of HF development (HR=1.39 for age < 65 years; HR=1.33 for age ≥65 years; HR=1.45 for men; and HR=1.36 for women). Conclusion: RVO was associated with HF development after adjusting for potential confounders. These findings were limited to Korean population and should be validated by additional observational studies.
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