Abstract
BACKGROUND: Retinal artery occlusion (RAO) is a devastatingly vision threatening disease. Affected patients usually experience acute, sudden painless visual loss. RAO can be considered as a stroke of eye and systemic cardiovascular diseases have been well known to be associated with RAO. On the other hand, end-stage renal disease (ESRD), the far-advanced stage of chronic kidney disease (CKD), is considered as a risk factor for development of cardiovascular disease. We conducted a population based retrospective cohort study to assess the association of ESRD and RAO. METHODS: This study was based on the longitudinal data from the Taiwan National Health Insurance (TNHI) Research Database. The study cohort comprised 5,181 ESRD patients during the period from January 1996 to December 2011. For each ESRD patient, five patients were randomly selected from the same database, matched for age, gender, hypertension, hypercholesterolemia, and diabetes mellitus (DM). The association between ESRD and RAO was assessed by stratified Cox proportional hazard models, adjusting for potential confounders. Kaplan- Meier analysis was used to compare RAO-free rate between the ESRD and non-ESRD cohorts. RESULTS: The 16-year cumulative incidence of RAO for ESRD cohort was 2.4 folds of that for non- ESRD cohort (0.31% vs. 0.13%, P = 0.004). After adjustment of potential confounders, the risk of RAO is significant in ESRD patients (adjusted hazard ratio [HR] = 3.80; 95% confidence interval [CI]: 1.82–7.9, P = 0.0004). Kaplan-Meier survival analysis indicated that the probability of RAO-free was lower in ESRD cohort than comparison cohort (log-rank test, P < 0.0001). CONCLUSION: The results of our study showed ESRD patients had significantly increased risk of RAO compared with non-ESRD patients, independent of potential confounders.
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