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Zhang W, Guo X, Jiang X, Liu J, Han X, Guo C. RETINAL MICROVASCULAR CHANGES AND RISK OF CORONARY HEART DISEASE: A Systematic Review and Meta-Analysis. Retina 2024; 44:333-344. [PMID: 37831943 DOI: 10.1097/iae.0000000000003959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2023]
Abstract
PURPOSE To quantify associations between various retinal microvascular changes and the risk of the development of coronary heart disease (CHD). METHODS PubMed, Embase, Web of Science, and Cochrane Library databases were searched for cohort studies on the association between retinal microvascular changes and incident CHD up to July 31, 2023. The summary risk estimates were estimated using the random-effects model. Subgroup and sensitivity analyses were performed to investigate the potential source of heterogeneity. RESULTS The authors identified 21 studies that met the inclusion criteria of this meta-analysis through database searching. This study yielded significant associations between retinal microvascular changes, including arteriolar narrowing, venular widening, vessel occlusion, and other retinal vascular signs, and the risk of CHD, with pooled adjusted hazard ratios of 1.20 (95% confidence interval: 1.13-1.27). In sex- and age-stratified analyses, retinal microvascular changes were associated with a greater risk of developing CHD in female patients and younger adults. CONCLUSION A range of retinal microvascular changes was associated with the risk of CHD, particularly in female patients and younger ages. The results of this study support the concept that retinal microvascular abnormalities may be markers for future CHD. Noninvasive retinal microvascular assessments may be helpful in screening patients with increased CHD risk.
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Affiliation(s)
- Wenyi Zhang
- Cardiovascular Center, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China
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Valeriani E, Paciullo F, Porfidia A, Pignatelli P, Candeloro M, Di Nisio M, Donadini MP, Mastroianni CM, Pola R, Gresele P, Ageno W. Antithrombotic treatment for retinal vein occlusion: a systematic review and meta-analysis. JOURNAL OF THROMBOSIS AND HAEMOSTASIS : JTH 2023; 21:284-293. [PMID: 36700511 DOI: 10.1016/j.jtha.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 09/16/2022] [Accepted: 10/05/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND Retinal vein occlusion (RVO) represents a common thrombotic disorder. OBJECTIVES In this meta-analysis, we evaluated the efficacy and safety of anticoagulant and antiplatelet therapy in RVO. METHODS MEDLINE and EMBASE were searched up to December 2021 for observational studies and randomized controlled trials including patients with RVO. Efficacy outcomes were best-corrected visual acuity improvement, recurrent RVO, fluorescein angiography improvement, cardiovascular events, and safety outcomes were major bleeding and intraocular bleeding. RESULTS A total of 1422 patients (15 studies) were included. Antiplatelet therapy was administered to 477 patients (13 studies), anticoagulant therapy to 312 patients (12 studies), and 609 (7 studies) patients received no antithrombotic treatment. The treatment duration ranged between 0.5 and 3 months. The median follow-up duration was 12 months. Best-corrected visual acuity improvement was reported in 58% of the patients (95% confidence interval [CI], 45%-69%) overall, 64% (95% CI, 58%-71%) in those on anticoagulant therapy, and 33% (95% CI, 21%-47%) in those on antiplatelet therapy. The rates of recurrent RVO was 11% (95% CI, 7%-17%), 7% (95% CI, 2%-19%), and 15% (95% CI, 8%-28%), respectively. The rate of recurrent RVO in untreated patients was 9% (95% CI, 6%-14%). The rate of major bleeding was 5% (95% CI, 3%-9%) overall, 4% (95% CI, 2%-9%) in those on anticoagulant therapy, and 7% (95% CI, 2%-23%) in those on antiplatelet therapy. CONCLUSION Anticoagulant therapy was associated with higher visual acuity improvement and fewer recurrent RVO events than antiplatelet therapy, at the cost of an acceptable proportion of bleeding complications.
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Affiliation(s)
- Emanuele Valeriani
- Department of Infectious Disease, Azienda Ospedaliero-Universitaria Policlinico Umberto I, Rome, Italy; Paride Stefanini" Department, Sapienza University of Rome, Rome, Italy.
| | - Francesco Paciullo
- Department of Medicine and Surgery, Division of Internal and Cardiovascular Medicine, University of Perugia, Perugia, Italy
| | - Angelo Porfidia
- Department of Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Matteo Candeloro
- Department of Innovative Technologies in Medicine and Dentistry, "G. D'Annunzio" University, Chieti, Italy
| | - Marcello Di Nisio
- Department of Medicine and Ageing Sciences, University "G D'Annunzio", Chieti-Pescara, Italy
| | | | - Claudio Maria Mastroianni
- Department of Infectious Disease, Azienda Ospedaliero-Universitaria Policlinico Umberto I, Rome, Italy
| | - Roberto Pola
- Department of Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Paolo Gresele
- Department of Medicine and Surgery, Division of Internal and Cardiovascular Medicine, University of Perugia, Perugia, Italy
| | - Walter Ageno
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
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Umeya R, Yoshida Y, Ono K. Impact of retinal vein occlusion on cardiovascular events in elderly Japanese patients. Medicine (Baltimore) 2021; 100:e28424. [PMID: 34967379 PMCID: PMC8718221 DOI: 10.1097/md.0000000000028424] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 12/06/2021] [Indexed: 01/05/2023] Open
Abstract
To assess the relationship between retinal vein occlusion (RVO) and the incidence of cardiovascular (CV) events.This was a single-institution, retrospective cohort study. We enrolled 57 patients diagnosed with RVO between January 2012 and December 2019, and 125 non-RVO patients who had undergone cataract surgery by a single surgeon between January and April 2012. We compared the relative risk and incidence rate ratio of CV events between the 2 groups. In addition, survival analysis was performed to calculate the hazard ratio (HR) using the Cox proportional hazards model. RVO, age, sex, blood pressure, body mass index, presence of diabetes, blood sample data, and smoking were considered confounders.The mean observation period (± standard deviation) for the RVO and non-RVO groups was 2.68 ± 2.04 and 2.81 ± 2.70 years, respectively. Seven CV events were observed in the RVO group and 2 in the non-RVO group. Relative risk and incidence rate ratio were 7.68 (95% confidence interval [CI]: 1.65-35.8) and 8.07 (95% CI: 1.54-79.6), respectively. Multivariate analysis revealed that the RVO group had a high HR for CV events (HR: 16.13 [95% CI: 2.29-113.74]) and older age (HR: 1.26 [95% CI: 1.06-1.49]).RVO can predict future CV events, especially in the elderly population. Fundus observations should be shared between ophthalmologists and internists to prevent future CV events.
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Affiliation(s)
- Reiko Umeya
- Department of Ophthalmology, Juntendo Tokyo-Koto Geriatric Medical Center, Juntendo University School of Medicine, Tokyo, Japan
| | - Yuto Yoshida
- Department of Ophthalmology, Juntendo Tokyo-Koto Geriatric Medical Center, Juntendo University School of Medicine, Tokyo, Japan
- Department of Ophthalmology, Juntendo University School of Medicine, Tokyo, Japan
| | - Koichi Ono
- Department of Ophthalmology, Juntendo Tokyo-Koto Geriatric Medical Center, Juntendo University School of Medicine, Tokyo, Japan
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ASSOCIATION OF RETINAL VEIN OCCLUSION WITH CARDIOVASCULAR EVENTS AND MORTALITY: A Systematic Review and Meta-analysis. Retina 2020; 39:1635-1645. [PMID: 30829987 DOI: 10.1097/iae.0000000000002472] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
PURPOSE Previous studies examining the association of retinal vein occlusion (RVO) and cardiovascular events have been inconsistent and have mostly focused on stroke and myocardial infarction. The goal of this study is to use meta-analysis to examine the available evidence examining the association of RVO with incident cardiovascular events and mortality. METHODS Systematic review and meta-analysis of all longitudinal cohort studies published in PubMed, Embase, and the Cochrane Library from inception to April 7, 2018, that evaluated the association of baseline RVO and incident cardiovascular events and/or mortality, that provided multivariate-adjusted risk estimates with 95% confidence intervals (95% CIs), and that had average follow-up ≥1 year. The Newcastle-Ottawa scale was used to assess study quality. Multivariate-adjusted risk estimates with 95% CI along with study characteristics were extracted from each study, and pooled risk ratios (RRs) with 95% CI were generated using a random-effects model with inverse-variance weighting to account for heterogeneity. Main outcomes were incident stroke (fatal or nonfatal), myocardial infarction, heart failure, peripheral arterial disease, all-cause mortality, and cardiovascular mortality. RESULTS Fifteen cohort studies with a total of 474,466 patients (60,069 with RVO and 414,397 without RVO) were included. Each study had Newcastle-Ottawa scale score ≥6, indicating moderate-to-high quality. Retinal vein occlusion was associated with increased risk of stroke (RR = 1.45; 95% CI, 1.31-1.60), myocardial infarction (RR = 1.26; 95% CI, 1.17-1.37), heart failure (RR = 1.53; 95% CI, 1.22-1.92), peripheral arterial disease (RR = 1.26; 95% CI, 1.09-1.46), and all-cause mortality (RR = 1.36; 95% CI, 1.02-1.81), but was not associated with increased risk of cardiovascular mortality (RR = 1.78; 95% CI, 0.70-4.48). CONCLUSION This review suggests patients with RVO have an increased risk of cardiovascular events and all-cause mortality. More studies are needed to determine the highest risk periods for cardiovascular events and mortality after RVO and whether immediate cardiovascular evaluation and intervention will improve outcomes.
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Gao Q, Peng B, Huang X, Qi CX, Tong Y, Deng QQ, Shen Y. Assessment of cerebral low-frequency oscillations in patients with retinal vein occlusion: a preliminary functional MRI study. Acta Radiol 2020; 61:813-820. [PMID: 31604375 DOI: 10.1177/0284185119879683] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND There is increasing evidence that patients with retinal vein occlusion exhibit cerebral vascular changes and are at an increased risk of stroke. However, it remains unknown whether patients with retinal vein occlusion exhibit changes in intrinsic brain activity. PURPOSE This study investigated intrinsic brain activity changes in patients with retinal vein occlusion by assessing the amplitude of low-frequency fluctuations. MATERIAL AND METHODS Forty-five patients with retinal vein occlusion (22 men, 23 women, mean age 56.55 ± 6.97 years) and 43 healthy controls (13 men, 30 women; mean age 53.53 ± 8.19 years) closely matched in age, sex, and education level underwent resting-state MRI scans. The amplitude of low-frequency fluctuation method was used to compare intrinsic brain activity between the two groups. RESULTS Compared with healthy controls, patients with retinal vein occlusion exhibited significantly lower amplitude of low-frequency fluctuation values in the left middle occipital gyrus, right middle occipital gyrus, and right calcarine. However, patients with retinal vein occlusion showed significantly higher amplitude of low-frequency fluctuations in the bilateral cerebellum 6, right hippocampus, left insula, and left fusiform (voxel-level P < 0.01, Gaussian random field correction, cluster-level P < 0.05). CONCLUSION Our results demonstrated that patients with retinal vein occlusion showed abnormal spontaneous neural activities in the visual cortices, cerebellum, and Papez circuit, which might indicate impaired vision, cognition, and emotional function in patients with retinal vein occlusion. These findings offer important insights into the neural mechanism of retinal vein occlusion.
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Affiliation(s)
- Qing Gao
- Eye Center, Renmin Hospital of Wuhan University, Wuhan, Hubei, PR China
| | - Bin Peng
- Eye Center, Renmin Hospital of Wuhan University, Wuhan, Hubei, PR China
| | - Xin Huang
- Eye Center, Renmin Hospital of Wuhan University, Wuhan, Hubei, PR China
| | - Chen-Xing Qi
- Eye Center, Renmin Hospital of Wuhan University, Wuhan, Hubei, PR China
| | - Yan Tong
- Eye Center, Renmin Hospital of Wuhan University, Wuhan, Hubei, PR China
| | - Qin-Qin Deng
- Eye Center, Renmin Hospital of Wuhan University, Wuhan, Hubei, PR China
| | - Yin Shen
- Eye Center, Renmin Hospital of Wuhan University, Wuhan, Hubei, PR China
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Abstract
Retinal vein occlusion (RVO) is the second most common etiology for vision loss. There is contrasting evidence on the association between diabetes mellitus (DM) and the risk of RVO. We performed a meta-analysis of published articles before October 31, 2019, to estimate a pooled odds ratio for the association between DM and RVO, including central and branch RVO by a fixed or random effects model. We identified 37 publications from 38 studies (1 publication was from 2 studies), published between 1985 and 2019. In total, 148,654 cases and 23,768,820 controls were included in this meta-analysis. The results of pooled analysis for all 37 publications (or 38 studies) showed a significant association between DM and the risk of RVO (OR = 1.68, 95% CI: 1.43-1.99). Subgroup analysis indicated that DM was significantly associated with CRVO (OR = 1.98, 95% CI: 1.29-3.03, I = 67.9%), but not significantly associated with BRVO (OR = 1.22, 95% CI: 0.95-1.56, I = 64.1%). In conclusion, the result of present meta-analysis suggested that DM is a risk factor for RVO. More well-designed studies on the relationship between RVO and DM should be undertaken in the future.
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Affiliation(s)
- Yun Wang
- Department of Ophthalmology, Ningbo Eye Hospital, Ningbo
| | - Shanjun Wu
- Department of Ophthalmology, Ningbo Eye Hospital, Ningbo
| | - Feng Wen
- Department of Ophthalmology, Ningbo Eye Hospital, Ningbo
| | - Qixin Cao
- Department of Ophthalmology, Huzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University, Huzhou, Zhejiang, China
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Chen YY, Sheu SJ, Hu HY, Chu D, Chou P. Association between retinal vein occlusion and an increased risk of acute myocardial infarction: A nationwide population-based follow-up study. PLoS One 2017; 12:e0184016. [PMID: 28898259 PMCID: PMC5595302 DOI: 10.1371/journal.pone.0184016] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Accepted: 08/16/2017] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To investigate a possible association between retinal vein occlusion (RVO) and an increased risk of developing acute myocardial infarction (AMI). DESIGN A population-based retrospective cohort study using the entire population of the Taiwan National Health Insurance Research Database (NHIRD) from 1st January, 2001 to 31st December, 2013. METHODS A total of 37921 subjects with RVO were enrolled in the RVO group, and 113763 subjects without RVO were enrolled in the comparison group. The comparison group consisted of randomly selected individuals who were propensity score (PS)-matched with the RVO group at a ratio of 1:3, based on age, gender, obesity, stroke, hyperviscosity syndrome, glaucoma, and the use of antithrombotic drugs. A log-rank test was used to compare the cumulative hazard of AMI between the two groups. A multivariate Cox regression analysis was used to estimate the adjusted hazard ratios (HRs) of AMI, adjusted for PS, diabetes, hypertension, hyperlipidemia, congestive heart failure, and chronic renal failure. RESULTS The mean age of the cohort was 62.4±13.2 years. RVO patients had significantly higher proportions of diabetes, hypertension, hyperlipidemia, congestive heart failure, and chronic renal failure than the comparisons. The mean follow-up period was 5.52 years in the RVO group and 5.55 years in the comparison group (p = 0.16). A log-rank test comparing the cumulative hazard curves of AMI for the two groups revealed a significant difference (p<0.0001). In the multivariate Cox regression after adjustment for PS and confounders, the RVO group had a significantly higher risk of AMI (adjusted HR = 1.21; 95% CI: 1.13 to 1.30). When the RVO group was divided into central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO) and analyzed separately, both groups had significantly higher adjusted HRs for developing AMI than the comparison group. Moreover, the CRVO group had a significantly higher risk of AMI than the BRVO group. CONCLUSIONS People with RVO are at significantly greater risk of developing AMI than individuals without RVO.
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Affiliation(s)
- Yu-Yen Chen
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Department of Ophthalmology, National Yang-Ming University Hospital, Yilan City, Yilan County, Taiwan
- Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
| | - Shwu-Jiuan Sheu
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Hsiao-Yun Hu
- Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan
| | - Dachen Chu
- Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan
- Deputy Superintendent, Taipei City Hospital, Taipei, Taiwan
| | - Pesus Chou
- Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
- * E-mail:
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Abstract
PURPOSE It is unknown whether sudden vision loss (SVL) is an independent marker for future cardiovascular disease (CVD) events in African Americans. We examined the hazard of future stroke or myocardial infarction (MI) and mortality associated with self-reported SVL lasting 24 hours or longer in a cohort of African Americans enrolled in the Jackson Heart Study (JHS). METHODS The study sample comprised 4670 African Americans aged 20-95 years enrolled in the JHS without previous coronary heart disease or stroke at baseline. All participants who responded to the question "Have you ever had any sudden loss of vision or blurring, lasting 24 hours or longer?" on the baseline stroke questionnaire were included in the study. Ten years of follow-up data was used. Cox proportional hazards modeling was used to examine the association between SVL (n = 142) and risk of future stroke/MI and mortality. RESULTS In age- and sex-adjusted Cox models, SVL was significantly associated with higher hazards of future stroke/MI (hazard ratio, HR, 2.08, 95% confidence interval, CI, 1.09-3.96) and mortality (HR 1.73, 95% CI 1.07-2.78). After adjusting for diabetes mellitus, total/high-density lipoprotein cholesterol ratio, smoking, hypertension and income, the relationships between SVL and future stroke/MI (adjusted HR 1.51, 95% CI 0.78-2.90) or mortality (adjusted HR 1.29, 95% CI 0.78-2.11) were no longer significant. CONCLUSIONS Self-reported SVL lasting 24 hours or longer was significantly associated with future stroke/MI and mortality, but its effect is likely a surrogate for underlying CVD risk factors rather than being an independent predictor.
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Affiliation(s)
- Paul B Greenberg
- a Division of Ophthalmology , Alpert Medical School, Brown University , Providence , RI , USA.,b School of Public Health , Brown University , Providence , RI , USA.,c Section of Ophthalmology , Providence VA Medical Center , Providence , RI , USA
| | - Allison J Chen
- a Division of Ophthalmology , Alpert Medical School, Brown University , Providence , RI , USA.,b School of Public Health , Brown University , Providence , RI , USA.,c Section of Ophthalmology , Providence VA Medical Center , Providence , RI , USA
| | - Wen-Chih Wu
- d Division of Cardiology , Alpert Medical School, Brown University , Providence , RI , USA.,e Section of Cardiology , Providence VA Medical Center , Providence , RI , USA
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Woo SCY, Lip GYH, Lip PL. Associations of retinal artery occlusion and retinal vein occlusion to mortality, stroke, and myocardial infarction: a systematic review. Eye (Lond) 2016; 30:1031-8. [PMID: 27256303 DOI: 10.1038/eye.2016.111] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 04/20/2016] [Indexed: 11/09/2022] Open
Abstract
Retinal vascular events are perceived to be related to various cardiovascular complications. We conducted a systematic review to assess the relationship between retinal artery/vein occlusions (RAO/RVO) and the incidence of mortality, stroke, and myocardial infarction (MI). A comprehensive electronic literature search selected 93 relevant studies between 1992-2015: 16 articles qualified for inclusion (7 for mortality rate and MI, 11 for stroke). No published articles examined associations of RAO to mortality or MI, but only to stroke. Because of the heterogeneity of studies, no meta-analysis was performed. The association with mortality risk was highest at ~34.7% in RVO subgroup; whereas for MI, the risk was comparatively lower at 3.9-5.7% for RVO. There was no significant difference in stroke rate when comparing central and branch RVO subgroups (6.5%), but was significantly higher at 19.6-25% in RAO. There is a positive association of retinal vascular events to mortality, stroke, and MI. RAO is associated with a higher risk of stroke. Given that RAO and RVO patients would generally present to ophthalmologists, their high cardiovascular risk should include a referral for cardiovascular assessment as part of their management protocol.
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Affiliation(s)
- S C Y Woo
- University of Birmingham Institute of Cardiovascular Sciences, City Hospital, Birmingham, UK
| | - G Y H Lip
- University of Birmingham Institute of Cardiovascular Sciences, City Hospital, Birmingham, UK.,Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - P L Lip
- Birmingham and Midland Eye Centre, City Hospital, Birmingham, UK
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Zhou Y, Zhu W, Wang C. Relationship between retinal vascular occlusions and incident cerebrovascular diseases: A systematic review and meta-analysis. Medicine (Baltimore) 2016; 95:e4075. [PMID: 27368050 PMCID: PMC4937964 DOI: 10.1097/md.0000000000004075] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Several studies investigating the role of retinal vascular occlusions, on cerebrovascular diseases (CVD) have been reported, but the results are still inconsistent. We therefore sought to evaluate the relationship between retinal vascular occlusions and CVD.We systematically searched the Cochrane Library, PubMed, and ScienceDirect databases through January 31, 2016 for studies evaluating the effect of retinal vascular occlusions on the risk of CVD. Data were abstracted using predefined criteria, and then pooled by RevMan 5.3 software.A total of 9 retrospective studies were included in this meta-analysis. When compared with individuals without retinal vascular occlusions, both individuals with retinal artery occlusion (RAO) (odds ratio [OR] = 2.01, 95% confidence interval [CI]: 1.21-3.34; P = 0.005) and individuals with retinal vein occlusion (RVO) (OR = 1.37, 95% CI: 1.24-1.50; P < 0.00001) had higher risks of developing CVD. Additionally, both individuals with central retinal artery occlusion (CRAO) (OR = 2.00, 95% CI: 1.12-3.56; P = 0.02) and branch retinal artery occlusion (BRAO) (OR = 1.60, 95% CI: 1.03-1.48; P = 0.04) were significantly associated with increased risk of CVD.Published literatures support both RVO and RAO are associated with increased risks of CVD. Further prospective studies are needed to confirm these findings.
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Affiliation(s)
| | - Wengen Zhu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Changyun Wang
- Department of Ophthalmology
- Correspondence: Changyun Wang, Department of Ophthalmology, the Second Affiliated Hospital of Nanchang University, Jiangxi 330006, China (e-mail: )
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11
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Retinal vein occlusion and risk of cerebrovascular disease and myocardial infarction: A meta-analysis of cohort studies. Atherosclerosis 2016; 247:170-6. [DOI: 10.1016/j.atherosclerosis.2016.02.024] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 02/13/2016] [Accepted: 02/17/2016] [Indexed: 11/20/2022]
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Retinal vein occlusion and the risk of acute myocardial infarction development: a 12-year nationwide cohort study. Sci Rep 2016; 6:22351. [PMID: 26924150 PMCID: PMC4770309 DOI: 10.1038/srep22351] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 02/12/2016] [Indexed: 12/26/2022] Open
Abstract
The goal of this study was to evaluate the risk of developing acute myocardial infarction (AMI) following retinal vein occlusion (RVO). A retrospective cohort study was performed from the National Health Insurance Service and comprised 1,025,340 random subjects who were followed from 2002 to 2013. Patients with RVO in 2002 were excluded. The RVO group was composed of patients who received an initial RVO diagnosis between January 2003 and December 2007 (n = 1677). The comparison group was selected (five patients per RVO patient; n = 8367) using propensity score matching according to sociodemographic factors and the year of enrolment. Each patient was tracked until 2013. The Cox proportional hazard regression model was used. AMI developed in 7.6% of the RVO group and 5.3% of the comparison group (p < 0.001) for 7.7 median follow-up periods. RVO increased the risk of AMI development [hazard ratio (HR) = 1.25; 95% Confidence Interval (CI) 1.02 to 1.52]. In the subgroup analysis, RVO patients aged <65 years and the males within this age group had an adjusted HR of 1.47 (95% CI 1.10 to 1.98) and an adjusted HR of 2.00 (95% CI 1.38 to 2.91) for AMI development, respectively. RVO was significantly associated with AMI development.
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Mrad M, Fekih-Mrissa N, Wathek C, Sayeh A, Maalej A, Rannen R, Nsiri B. Role of the Apolipoprotein E Polymorphisms in the Development of Retinal Vein Occlusion in a Tunisian Population: A Case–Control Study. Clin Appl Thromb Hemost 2016; 23:645-651. [DOI: 10.1177/1076029616629212] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Apolipoprotein E ( APOE) is a member of the apolipoprotein gene family. APOE is polymorphic with 3 main allelic types: ∊2, ∊3, and ∊4. Certain of these alleles have been associated with higher vascular risk. However, the association of APOE genotypes with retinal biomarkers and risk of retinal stroke is less clear. This study evaluated the role of APOE polymorphisms in retinal vein occlusion (RVO). In the present study, 2-point mutations coding amino acid residues 112 and 158 were amplified using the polymerase chain reaction (PCR) from DNA extracted from Tunisian participants. APOE genotypes were determined by multiplex PCR followed by molecular hybridization. Eighty-eight patients (26 women and 62 men) and 100 age- and gender-matched healthy participants were enrolled. The statistical study revealed a higher frequency of the ∊4 allele in patients as compared to controls (27.3% vs 9%) with a significant association of the ∊4 allele with the disease ( P < 10−3, Pa < 10−3, odds ratio [OR] = 3.8, 95% confidence interval [CI] = 2.1-6.8). The frequency of the ∊3 allele was significantly lower in the patients with RVO compared to the controls (60.2% vs 82.5%, respectively; P < 10−3, Pa < 10−3, OR = 0.32, 95% CI = 0.19-0.53). The ∊3 allele seems to be protective against the disease. There was no association between the APO ∊2 allele and RVO. The association of APOE allele and genotype with RVO requires further investigation in different populations.
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Affiliation(s)
- Meriem Mrad
- Laboratoire de Biologie Moléculaire, Service d’Hématologie Hôpital Militaire Principal d’Instruction de Tunis, Montfleury, Tunisie
- Faculté des Science de Tunis, Université Tunis el Manar, El Manar, Tunisie
| | - Najiba Fekih-Mrissa
- Laboratoire de Biologie Moléculaire, Service d’Hématologie Hôpital Militaire Principal d’Instruction de Tunis, Montfleury, Tunisie
- Académie Militaire Fondouk Jédid, Nabeul, Tunisie
| | - Cheima Wathek
- Service d’Ophtalmologie, Hôpital Militaire Principal d’Instruction de Tunis, Montfleury, Tunisie
- Faculté de Médecine de Tunis, Université Tunis el Manar, Tunis, Tunisie
| | - Aicha Sayeh
- Laboratoire de Biologie Moléculaire, Service d’Hématologie Hôpital Militaire Principal d’Instruction de Tunis, Montfleury, Tunisie
- Faculté des Science de Tunis, Université Tunis el Manar, El Manar, Tunisie
| | - Afef Maalej
- Service d’Ophtalmologie, Hôpital Militaire Principal d’Instruction de Tunis, Montfleury, Tunisie
- Faculté de Médecine de Tunis, Université Tunis el Manar, Tunis, Tunisie
| | - Riadh Rannen
- Service d’Ophtalmologie, Hôpital Militaire Principal d’Instruction de Tunis, Montfleury, Tunisie
- Faculté de Médecine de Tunis, Université Tunis el Manar, Tunis, Tunisie
| | - Brahim Nsiri
- Laboratoire de Biologie Moléculaire, Service d’Hématologie Hôpital Militaire Principal d’Instruction de Tunis, Montfleury, Tunisie
- Faculté de Pharmacie, Université de Monastir, Monastir, Tunisie
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Park SJ, Choi NK, Yang BR, Park KH, Woo SJ. Risk of stroke in retinal vein occlusion. Neurology 2015; 85:1578-84. [DOI: 10.1212/wnl.0000000000002085] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Accepted: 07/02/2015] [Indexed: 11/15/2022] Open
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15
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Rim TH, Kim DW, Han JS, Chung EJ. Retinal Vein Occlusion and the Risk of Stroke Development. Ophthalmology 2015; 122:1187-94. [DOI: 10.1016/j.ophtha.2015.01.020] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 01/06/2015] [Accepted: 01/22/2015] [Indexed: 11/26/2022] Open
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16
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Di Minno MND, Tufano A, Ageno W, Prandoni P, Di Minno G. Identifying high-risk individuals for cardiovascular disease: similarities between venous and arterial thrombosis in perspective. A 2011 update. Intern Emerg Med 2012; 7:9-13. [PMID: 21461594 DOI: 10.1007/s11739-011-0582-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2010] [Accepted: 03/17/2011] [Indexed: 01/10/2023]
Abstract
The aim of this narrative review is to assess the potential association between arterial and venous thrombotic events. Several studies have suggested that the major cardiovascular risk factors, alone or in combination (e.g. in the metabolic syndrome), are significantly associated with venous thromboembolism (VTE). Recent evidence also suggests that microalbuminuria and non-alcoholic liver steatosis, both markers of arterial disease, may independently predict the risk for VTE. An association between a history of VTE and the risk of future arterial events is also well documented, inflammation and endothelial dysfunction being thought as the common soil on which further investigation in the area should be pursued. The existence of a common pathophysiologic background is also suggested by the evidence that aspirin, low-molecular weight heparin (LMWH) and warfarin are recommended for the prevention and treatment of both venous and arterial thrombosis. In addition, rosuvastatin recently has been shown to prevent venous thromboembolism (VTE) in a time-dependent fashion. Together, these data argue for patients with a history of VTE as being at intermediate/high cardiovascular risk, a concept that implies that VTE patients should undergo a careful assessment for the presence of cardiovascular risk factors and adequate lifestyle changes. The value of routine screening for asymptomatic atherosclerosis (e.g. 2D echocardiography, microalbuminuria, arterial vessel ultrasonography) in these patients should be confirmed in future studies.
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