Cardiovascular risk factors for retinal vein occlusion and arteriolar emboli: the atherosclerosis risk in communities & cardiovascular health studies

Abstract

Objective: To examine the associations of retinal vein occlusion and arteriolar emboli with cardiovascular disease.

Design: Population-based cross-sectional study.

Participants: Pooled from the Atherosclerosis Risk in Communities Study (n = 12 642; mean age, 60 years) and the Cardiovascular Health Study (n = 2824; mean age, 79 years).

Methods: Retinal vein occlusion and arteriolar emboli were identified from a single nonmydriatic retinal photograph using a standardized protocol. Photographs were also graded for arteriovenous nicking and focal arteriolar narrowing. All participants had a comprehensive systemic evaluation, including standardized carotid ultrasonography.

Main Outcome Measures: Retinal vein occlusion and arteriolar emboli.

Results: Prevalences of retinal vein occlusion and arteriolar emboli were 0.3% (n = 39 cases) and 0.2% (n = 34 cases), respectively. After adjusting for age, retinal vein occlusion was associated with hypertension (odds ratio OR, 2.96; 95% confidence interval CI, 1.43­6.14), systolic blood pressure (BP) (OR, 4.12; 95% CI, 1.40­12.16; highest quartile vs. lowest), diastolic BP (OR, 2.64; 95% CI, 1.07­6.46; highest quartile vs. lowest), carotid artery plaque (OR, 5.62; 95% CI, 2.60­12.16), body mass index (OR, 3.88; 95% CI, 1.23­12.18; highest quartile vs. lowest), plasma fibrinogen (OR, 3.29; 95% CI, 1.08­10.02; highest quartile vs. lowest), arteriovenous nicking (OR, 4.09; 95% CI, 2.00­8.36), and focal arteriolar narrowing (OR, 5.17; 95% CI, 2.59­10.29). After adjusting for age, retinal arteriolar emboli were associated with hypertension (OR, 3.14; 95% CI, 1.44­6.84), systolic BP (OR, 3.46; 95% CI, 1.13­10.65; highest quartile vs. lowest), prevalent coronary heart disease (OR, 2.33! ; 95% CI, 1.01­5.42), carotid artery plaque (OR, 4.62; 95% CI, 1.85­11.57), plasma lipoprotein (a) (OR, 3.6 []