Prevalence of Retinal Vein Occlusion in the United States

Abstract

Background: Retinal vein occlusion (RVO) is the second most common cause of blindness among retinal vascular diseases. It consists of central retinal artery occlusion (CRAO), central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO). While the regional prevalence of RVO in the U.S. is 0.5 to 2 %, the national rate is still unknown. Therefore, we utilized a nationally representative sample collected by the National Health and Nutrition Examination Survey (NHANES) to better estimate the national prevalence and risk factors for RVO. Methods: The NHANES is a multi-ethnic study, which surveyed individuals from 30 different counties across the U.S. between 2005-2008. Besides demographic and medical diseases survey, participants underwent 45 degrees non-mydriatic retinal photography of both eyes. Out of 7081 cases, 1552 were excluded due to missing and ungradable images. For the remaining 5559 participants (2771 men and 2788 women), retinal scans were masked and evaluated by graders for the presence of RVO. We performed weighted analysis to estimate national prevalence rates and multivariate analysis to examine associated risk factors. Results: Out of 5559 subjects, 33 (20 men and 13 women, 0.59%) had RVO [27 (0.48%) BRVO, and 6 (0.11%) CRVO]. The overall national prevalence of BRVO, CRVO, and any RVO was 0.42% (95% CI = 0.23—0.60), 0.08% (95% CI = 0—0.18), and 0.50% (95% CI = 0.30—0.71), respectively. Multivariate analysis found that age, per 10-year increase (OR, 1.93; 95% CI = 1.31—2.92, P = 0.001) and elevated diastolic blood pressure, per 10 mm Hg increase (OR, 1.47; 95% CI = 1.10—2.12, P = 0.032) were significant risk factors for the prevalence of RVO. Race, gender, history of diabetes, stroke, and cardiovascular disease were not found to be significant risk factors. In univariate analysis glaucoma (P = 0.009) and total cholesterol (P =0.021) were significantly associated with RVO. Conclusion: Our study found that the overall national prevalence of RVO was 0.50%. In addition, older age and elevated diastolic BP were strongly associated with RVO. We recommend that patients with these characteristics undergo regular comprehensive ocular examination.