Prevalence and risk factors of retinal vein occlusion in individuals with diabetes: The kailuan eye study.

Vein Occlusion in Chinese Subjects

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Retinal vein occlusion (RVO) is a rare, vision-threatening vascular disorder. Due to limited recovery associated with RVO, prevention is essential. There is a significant discrepancy in previously reported epidemiological studies in the United States on the prevalence and risk factors of RVO. The purpose of this retrospective, cross-sectional study was to determine the prevalence and risk factors of RVO in adults ≥40 years of age in the US using the National Health and Nutrition Examination Survey (NHANES) 2005–2008. We collected information on the demographic characteristics, medical conditions, and ocular pathology of NHANES participants. We performed weighted analysis to estimate national prevalence rates and multivariate analysis to examine associated risk factors. The main outcome measures were the prevalence of RVO and the odds ratios of associated risk factors. We included 5559 participants and found 33 cases of RVO. The overall prevalence of RVO in the US was 0.50%. Age, per 10-year increase (odds ratio [OR], 1.93; 95% confidence interval [CI], 1.31–2.92) and elevated diastolic blood pressure, per 10 mm Hg increase (OR 1.47; 95% CI, 1.10–2.12) were significant risk factors for RVO. Race, sex, glaucoma, elevated cholesterol, and self-reported history of diabetes, stroke, and heart disease were not significant risk factors. RVO is significantly associated with older age and elevated diastolic blood pressure. Our findings should alert clinicians to identify individuals at risk for RVO.

To determine the prevalence of retinal vein occlusions (RVOs) in rural central India. The population-based Central India Eye and Medical Study was performed in rural central India and included 4,711 subjects (30 years and older). Using fundus photographs, we assessed the prevalence of branch retinal vein occlusions and central retinal vein occlusions. An RVO was detected in 38 eyes (0.42 ± 0.07%; 95% confidence interval: 0.29-0.56) of 35 subjects (0.76 ± 0.13%; 95% confidence interval: 0.50-1.01). Prevalence of branch retinal vein occlusions was 0.66% ± 0.12% per subject (95% confidence interval: 0.42%-0.90%) and of central retinal vein occlusions was 0.11% ± 0.05% per subject (95% confidence interval: 0.01%-0.21%). In binary logistic analysis, presence of RVOs was associated with higher age (P = 0.007), systolic blood pressure (P < 0.001), blood concentration of urea (P = 0.02), and narrower anterior chamber angle (P < 0.03). The RVO prevalence was not significantly (all Ps > 0.10) associated with body mass index; blood concentrations of glucose, cholesterol, high-density lipoproteins, and creatinine; presence of diabetes mellitus, tuberculosis and malaria; nutritional parameters; alcohol consumption; refractive error; and optic disk size. The age-specific prevalence rates of RVOs were 0.18% ± 0.13%, 0.29% ± 0.15%, 0.89% ± 0.34%, 1.07% ± 0.36%, 2.72% ± 0.85%, and 3.64% ± 2.55%, respectively, for decadal age groups. In two (5%) eyes, RVO had caused low vision (visual acuity <20/60 and ≥20/400). In the rural agrarian low-income population of Central India, RVOs were detected in 0.8% of adults, with branch retinal vein occlusions being approximately seven times more common than central retinal vein occlusions. Main associated factors were higher age, blood pressure, urea blood concentration, and narrow chamber angle. RVOs were no major reason for visual impairment.

Aim:To describe the prevalence and risk factors of retinal vein occlusion (RVO) in an Asian population.Methods:The Singapore Malay Eye Study is a population-based, cross-sectional study of 3280 (78.7%) Malay adults...

Purpose: The aim of this study was to examine the prevalence and incidence of retinal vein occlusions (RVO) in Europe. Methods: A systematic review and meta-analysis of the prevalence and incidence of RVO in Europe according to the Meta-Analyses of Observational Studies in Epidemiology (MOOSE) guidelines was performed in the databases PubMed, Embase and Web of Science. Based on Eurostat data, the total number of affected individuals in the EU was calculated and projected to the year 2050. Results: The random-effects pooled prevalence of RVO in Europe was 0.7% (95% CI: 0.5–0.9%) in persons aged 55 years and older based on the examination of 25,002 individuals from 4 prevalence studies. No European incidence studies were identified. The total number of affected individuals in the EU was estimated to rise by almost 20% from 900,000 today to 1.1 million in 2050. Conclusion: Published articles on the prevalence and incidence of RVO in Europe are limited. With the expected increase in affected persons, further epidemiological research is warranted for adequate healthcare planning.

Dear Editor, One of the most common ocular vascular diseases is retinal vein occlusion, the prevalence of which has been estimated to range from 0.3% to 1.6% in recent populationbased studies, such as the Blue Mountains Eye Study [1], the Beaver Dam Eye Study [2], a combined analysis of the Atherosclerosis Risk in Communities and Cardiovascular Health Studies [3], and the Singapore Malay Eye Study [4]. Considering that smoking is generally one of the major risk factors for vascular diseases, we addressed in our study whether smoking is associated with the prevalence of retinal vein occlusions. The Beijing Eye Study is a population-based study, which was first performed in 2001 and included 4,439 subjects (response rate: 83.4%) out of 5,324 subjects invited to participate, with an age of 40+ years. The study was repeated in 2006, with 3,251 subjects participating (response rate: 73.2%). The Medical Ethics Committee of the Beijing Tongren Hospital had approved the study protocol. The study has been described in detail recently [5]. Using fundus photographs (fundus camera: CR6-45NM, Canon Inc., USA), the prevalence of retinal vein occlusions was determined [5]. Recent retinal vein occlusions were characterized by the presence of retinal edema, optic disc hyperemia or edema, scattered superficial or deep hemorrhages, and venous dilatation. Old retinal vein occlusions were characterized by occluded and sheathed retinal veins. Additionally, we measured the systolic and diastolic blood pressure, and body height and body weight. Fasting blood samples were biochemically examined, and information was obtained about smoking habits. Glaucoma was defined by the appearance of the optic nerve head, as described in detail recently [5]. The study sample consisted of 3,214 subjects with a mean age of 55.3±10.0 years (range: 40–84 years) and a mean refractive error of −0.36±2.22 diopters (−20.1 diopters to +7.50 diopters). A retinal vein occlusion was detected in 37 subjects (1.2%). Out of the 3,214 subjects, 1,042 participants (32.4%) were current smokers (n=725; 16.3 % of the study population) or former smokers (n=317; 7.1% of the study population). In univariate analysis, prevalence of retinal vein occlusions was significantly associated with higher age (P<0.001), body mass index (P=0.001), mean arterial blood pressure (P=0.002), presence of glaucomatous optic nerve damage (P<0.001), and former smoking (P=0.002). In univariate analysis, retinal vein occlusions were not significantly associated with smoking as a whole group [P=0.16; odds ratio (OR): 1.60; 95% confidence interval (CI): 0.83, 3.07], nor with current smoking (P=0.43; OR: 0.66; 95% CI: 0.28, 1.59), level of education (P=0.15), gender (P=0.68), urban versus rural region (P=0.77), fasting blood levels of glucose Proprietary interest none

To examine the prevalence of retinal vein occlusion (RVO) and its systemic relevant factors in a general Japanese population aged 40 years or older. In 1998, 1775 Hisayama residents consented to participate in the study. Each participant underwent a comprehensive examination that included ophthalmic testing. RVO was determined by grading color fundus photographs. Logistic regression analysis was performed to determine risk factors for RVO. Of the 1775 subjects examined, 38 had RVO. The prevalence of RVO was 2.1% (2.0% for branch RVO and 0.2% for central RVO). After adjustment for age and sex, it was found that systolic and diastolic blood pressures, hypertension, and hematocrit were significantly associated with RVO. In multivariate analysis, age (per 10 years; odds ratio [OR], 1.47; 95% confidence interval [CI], 1.04-2.08), hypertension (OR, 4.25; 95% CI, 1.82-9.94), and hematocrit (per 10%; OR, 3.09; 95% CI, 1.10-1.22) remained independently significant risk factors for RVO. Both high-normal blood pressure and hypertension were significantly associated with RVO. Furthermore, compared with normotensive subjects without high hematocrit, the likelihood of RVO was markedly high in subjects having both high blood pressure and high hematocrit (age- and sex-adjusted OR, 36.0; 95% CI, 4.43-292). The findings suggest that the prevalence of RVO is higher in the Japanese than in other Asians or Caucasians and that older age, higher hematocrit, and both hypertension and high-normal blood pressure are significant risk factors for RVO in the Japanese.

PurposeTo investigate the prevalence of retinal vein occlusions (RVOs) and associated factors in a Chinese population.Patients and MethodsThe cross-sectional community-based Kailuan Eye Study included individuals who participated in the Kailuan Study. RVOs were diagnosed on the fundus photographs. Estimated cerebrospinal fluid pressure (eCSFP) was calculated as “eCSFP=0.44*Body Mass Index+0.16*Diastolic Blood Pressure-0.18*Age”.ResultsThe study included 12,499 participants with a mean age of 52.9±13.1 years. The overall prevalence of RVO was 120/12,499 or 0.96%, with branch RVOs observed in 116/12,499 individuals and central RVOs in 4/12,499 individuals. RVOs started at the optic disc in 19 participants (15.8% of all RVOs), and in 101 (84.2%) individuals arterio-venous crossings outside the optic disc. In multivariable analysis, a higher RVO prevalence was associated with older age (P<0.001), higher eCSFP (P<0.001), and higher fasting serum glucose concentration (P<0.001). Differentiating between RVOs at arterio-venous crossings and RVOs at the optic disc revealed that the prevalence of both RVO types was associated with higher eCSFP (P<0.001 and P=0.004, respectively) after adjusting for age and fasting serum glucose concentration.ConclusionIn this adult Chinese population recruited on a community basis, the prevalence of any RVO (mean: 0.96) was associated with older age, higher eCSFP and higher fasting serum glucose concentration. Higher eCSFP may play an etiologic role in RVOs.

In Australia, knowledge of the epidemiology of retinal vein occlusion remains scarce because of a paucity of recent population-based data. The National Eye Health Survey (2015-2016) provides an up-to-date estimate of the prevalence of retinal vein occlusion in non-Indigenous and Indigenous Australian adults. To determine the prevalence and associations of retinal vein occlusion in a national sample of Indigenous and non-Indigenous Australian adults. Population-based cross-sectional study. A total of 3098 non-Indigenous Australians (aged 50-98years) and 1738 Indigenous Australians (aged 40-92years) living in 30 randomly selected sites, stratified by remoteness. Retinal vein occlusions were graded from retinal photographs using standardized protocols and recorded as central retinal vein occlusion or branch retinal vein occlusion. Prevalence of retinal vein occlusion. In the non-Indigenous population, the sampling weight adjusted prevalence of any retinal vein occlusion was 0.96% (95% confidence interval: 0.59, 1.6), with branch retinal vein occlusion observed in 0.72% (95% confidence interval: 0.41, 1.2) and central retinal vein occlusion in 0.24% (95% confidence interval: 0.13, 0.47). Any retinal vein occlusion was found in 0.91% (95% confidence interval: 0.47, 1.7) of Indigenous Australians aged 40years and over, with branch retinal vein occlusion observed in 0.83% (95% confidence interval: 0.40, 1.7) and central retinal vein occlusion in 0.07% (95% confidence interval: 0.02, 0.32). Older age (odds ratio=1.64 per 10years, P=0.006) and the presence of self-reported diabetes (odds ratio=3.24, P=0.006) were associated with any retinal vein occlusion after multivariable adjustments. Retinal vein occlusion was attributed as the cause of monocular vision loss (<6/12) in seven (0.25%) non-Indigenous and six (0.36%) Indigenous participants. These data suggest that retinal vein occlusion is relatively uncommon in the non-Indigenous Australians aged 50years and over and Indigenous Australians aged 40years and over. Similar to previous Australian and international reports, the prevalence of retinal vein occlusion rose sharply with age.

To describe the prevalence of retinal vein occlusion (RVO) and its association with cardiovascular, inflammatory, and hematologic risk factors in a multiethnic cohort. This was a population-based, cross-sectional study of 6147 participants (whites, blacks, Hispanics, Chinese) from six U.S. communities. RVO was defined from retinal photographs taken from both eyes according to a standardized protocol. Risk factors were assessed from interviews, examinations, and laboratory and radiologic investigations. The prevalence of RVO was 1.1% (0.9% for branch RVO and 0.2% for central RVO) and was similar across different ethnic groups: 0.9% in whites, 1.2% in blacks, 1.2% in Hispanics, and 1.1% in Chinese (P = 0.76). Independent risk factors associated with RVO were hypertension (odds ratio [OR], 2.06; 95% confidence interval [CI], 1.18-3.59), older age (OR, 1.34; 95% CI, 1.00-1.81, per decade increase), less education (OR, 4.08; 95% CI, 2.20-7.54), hypertriglyceridemia (OR, 1.98; 95% CI, 1.10-3.56), renal dysfunction (OR, 1.85; 95% CI, 1.01-3.39), and the presence of retinal arteriovenous nicking (OR, 4.01; 95% CI, 2.06-7.81) and focal arteriolar narrowing (OR, 4.38; 95% CI, 1.44-13.34). RVO was not significantly associated with direct measures of subclinical atherosclerosis (e.g., carotid intima media thickness and coronary artery calcium scores) or markers of inflammation (e.g., C reactive protein, interleukin-6) and endothelial dysfunction (e.g., soluble intercellular adhesion molecule-1) or coagulation (e.g., D-dimer). The prevalence of RVO is similar across different racial/ethnic groups. In the general population, RVO is associated with hypertension, dyslipidemia, and renal dysfunction, but not with atherosclerotic disease, systemic inflammation, and hematologic abnormalities.

We conducted this study to determine the pattern and prevalence of retinal vein occlusion (RVO) in Bhutan to inform national health policy as no data has been compiled previously. A retrospective cross-sectional survey was conducted over 3 years, including all new RVO cases. For patients with bilateral RVO, one eye was chosen randomly. Demographic, clinical, and diagnostic details, including optical coherence tomography, fluorescein angiography, and fundus photography, were collected. Of 141 RVO new patients included, aged 50.5 ± 20.2 years, there were more males (62.4%) than females (37.6%) significantly (p = 0.031), and 59.6% of total patients were from an urban setting. Farmers were the most affected group (44, 31.2%), followed by housewives (34, 24.1%), and the working group (33, 23.4%). Blurry vision (64, 45.5%), sudden loss of vision (17, 12.1%), including unsatisfactory cataract surgery (8, 5.7%) were common presenting complaints. Systemic hypertension (HT) (36, 25.5%), and diabetes mellitus (DM) (17, 12.1%), were associated systemic diseases. The prevalence of RVO was 4.8% (141/2913 all new retinal patients over the survey). Branch RVO (BRVO) was the most common type (77, 54.6%), followed by central RVO (CRVO) 56, (39.7%), and hemi-central RVO (HCRVO) (8, 5.7%). Superotemporal BRVO was the most common subtype (30, 39%) followed by inferotempoal (19, 24.7%). Best correct visual acuity (BCVA) was worse than 6/60 in 38 eyes (25.5%). BCVA was not significantly different between BRVO and CRVO eyes. Intraocular pressure was significantly lower in HCRVO eyes (p = 0.015) compared to BRVO and CRVO eyes. In Bhutan, 8.5% of RVO patients were bilateral. HT was associated significantly as a risk factor. Incidental findings of RVO during routine eye check-up and evaluating for unsatisfactory cataract surgery were common. Therefore, Bhutan needs to control noncommunicable diseases such as diabetes and HT to reduce RVO, and RVO-related blindness and complications.

The Prevalence of Retinal Vein Occlusion: Pooled Data from Population Studies from the United States, Europe, Asia, and Australia

To quantify the burden of illness for incident branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO) in a commercially insured working-age (commercial) and Medicare US population. Retrospective cohort analysis of health care claims from 2003 through 2008 from commercial and Medicare patients with ≥2 outpatient diagnoses for BRVO or CRVO. The index date was the first retinal vein occlusion diagnosis. Patients with medical and pharmacy benefits were followed ≥1 year preindex and then between 1 year and 3 years postindex. Incidence and prevalence of retinal vein occlusion was determined. Burden of illness was compared with matched control subjects without retinal vein occlusion. The commercial sample comprised 1,188 CRVO and 2,252 BRVO cases, whereas the Medicare sample had 2,739 CRVO and 4,573 BRVO cases. Adjusted ratio of case-to-control, all-cause expenditures for commercial patients at 1 year and 3 years postindex were 1.88 and 1.68, respectively, for BRVO and 1.42 and 1.36, respectively, for CRVO. For Medicare patients, these were 1.29 and 1.13, respectively, for BRVO and 1.23 and 1.14, respectively, for CRVO. All comparisons were significant (P < 0.001). Health care utilization and expenditures for commercially insured working-age and Medicare patients with BRVO or CRVO were significantly greater than those for control subjects. Retinal vein occlusion development may be a marker for the increased severity of systemic vascular disease.

Retinal vein occlusion (RVO) is one of the most common causes of acquired retinal vascular anomalies in adults and is a common cause of visual loss. There is little data on the prevalence of RVO in the general population, although it is at least as early as 1855 and there are more than 3000 publications. The number of studies on the incidence of RVO is relatively small. Reduced vision in patients affected by RVO can result from retinal ischemia and/or accumulation of fluid in the center of the retina (macular edema). In this review, studies on epidemiology, prevalence, and incidence in central retinal vein occlusion and macular edema were summarized and evaluated.