Risk of Retinal Vascular Occlusive Disease in Patients with Aortic Stenosis

Objective: The intersection of aortic stenosis (AS) and retinal vascular occlusive disease (RVOD) underscores the need for comprehensive cardiovascular and ophthalmic evaluations in patients with either condition. We aimed to evaluate the risk of RVOD in the entire Korean population with AS. Design:...

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Main Authors: Minjeong Kim, MD, Eui-Young Choi, MD, PhD, Kunho Bae, MD, Ju-Yeun Lee, MD, PhD
Format: Article
Language:English
Published: Elsevier 2025-09-01
Series:Ophthalmology Science
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666914525000934
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author Minjeong Kim, MD
Eui-Young Choi, MD, PhD
Kunho Bae, MD
Ju-Yeun Lee, MD, PhD
author_facet Minjeong Kim, MD
Eui-Young Choi, MD, PhD
Kunho Bae, MD
Ju-Yeun Lee, MD, PhD
author_sort Minjeong Kim, MD
collection DOAJ
description Objective: The intersection of aortic stenosis (AS) and retinal vascular occlusive disease (RVOD) underscores the need for comprehensive cardiovascular and ophthalmic evaluations in patients with either condition. We aimed to evaluate the risk of RVOD in the entire Korean population with AS. Design: A population-based retrospective cohort study. Participants: We included 4094 patients with AS (2088 males) and 4094 age-, sex-, and index year-matched controls. Clinical and follow-up data of all patients diagnosed with AS and healthy controls from 2004 to 2015 were extracted from the Korean National Health Insurance Claim database. Methods: The risk of RVOD, including retinal vein occlusion and retinal artery occlusion, was compared between the AS and control groups. Competing analysis was used to obtain aHRs. The covariates used in the final analysis included age, sex, income, body mass index, fasting glucose, systolic blood pressure, cholesterol level, smoking, alcohol consumption, atrial fibrillation (AF), and myocardial infarction (MI). Main Outcome Measures: Adjusted hazard ratio (aHR) of RVOD, incidence rate of RVOD. Results: The incidence rate of RVOD per 100 000 was 495.3 in the AS group and 366.2 in the control group (P < 0.001). During a mean follow-up period of 8 years, the aHR of RVOD was 1.48 (95% confidence interval [CI]: 1.19–1.83) in the AS group compared with the control group. Even after adjusting for AF and MI, the incidence of RVOD remained consistently and significantly higher in patients with AS (aHR 1.29, 95% CI: 1.03–1.63). In the subgroup analysis based on age, the risk of RVOD was significantly higher in patients with AS across all age groups. However, this significance weakened after adjusting for MI in patients ≥80 years (aHR 7.47, 95% CI: 0.97–57.55) and for AF in patients ≥65 years (aHR 1.36, 95% CI: 0.92–2.03). Conclusions: The results suggest a possible clinical association between AS and subsequent RVOD. Continuous screening for ≥5 years for RVOD would be recommended in patients with AS. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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spelling doaj-art-e406c25fe3dc4c49bbc9cc3b75d588a32025-08-20T03:47:41ZengElsevierOphthalmology Science2666-91452025-09-015510079510.1016/j.xops.2025.100795Risk of Retinal Vascular Occlusive Disease in Patients with Aortic StenosisMinjeong Kim, MD0Eui-Young Choi, MD, PhD1Kunho Bae, MD2Ju-Yeun Lee, MD, PhD3Division of Cardiology, Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine, Goyang, South Korea; Division of Cardiology, Ewha Womans University Mokdong Hospital, Seoul, South Korea; Department of Medicine, Graduate School, Yonsei University, Seoul, South KoreaDivision of Cardiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South KoreaDepartment of Ophthalmology, Seoul National University Hopital, Seoul National University College of Medicine, Seoul, South KoreaDepartment of Ophthalmology, Myongji Hospital, Hanyang University College of Medicine, Goyang, South Korea; Department of Ophthalmology, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts; Correspondence: Ju-Yeun Lee, MD, PhD, Department of Ophthalmology, Myongji Hospital, Hanyang University College of Medicine, 55 Hwasu-ro 14beon-gil, Deogyang-gu, Goyang-si, Gyeonggi-do, Republic of Korea 10475.Objective: The intersection of aortic stenosis (AS) and retinal vascular occlusive disease (RVOD) underscores the need for comprehensive cardiovascular and ophthalmic evaluations in patients with either condition. We aimed to evaluate the risk of RVOD in the entire Korean population with AS. Design: A population-based retrospective cohort study. Participants: We included 4094 patients with AS (2088 males) and 4094 age-, sex-, and index year-matched controls. Clinical and follow-up data of all patients diagnosed with AS and healthy controls from 2004 to 2015 were extracted from the Korean National Health Insurance Claim database. Methods: The risk of RVOD, including retinal vein occlusion and retinal artery occlusion, was compared between the AS and control groups. Competing analysis was used to obtain aHRs. The covariates used in the final analysis included age, sex, income, body mass index, fasting glucose, systolic blood pressure, cholesterol level, smoking, alcohol consumption, atrial fibrillation (AF), and myocardial infarction (MI). Main Outcome Measures: Adjusted hazard ratio (aHR) of RVOD, incidence rate of RVOD. Results: The incidence rate of RVOD per 100 000 was 495.3 in the AS group and 366.2 in the control group (P < 0.001). During a mean follow-up period of 8 years, the aHR of RVOD was 1.48 (95% confidence interval [CI]: 1.19–1.83) in the AS group compared with the control group. Even after adjusting for AF and MI, the incidence of RVOD remained consistently and significantly higher in patients with AS (aHR 1.29, 95% CI: 1.03–1.63). In the subgroup analysis based on age, the risk of RVOD was significantly higher in patients with AS across all age groups. However, this significance weakened after adjusting for MI in patients ≥80 years (aHR 7.47, 95% CI: 0.97–57.55) and for AF in patients ≥65 years (aHR 1.36, 95% CI: 0.92–2.03). Conclusions: The results suggest a possible clinical association between AS and subsequent RVOD. Continuous screening for ≥5 years for RVOD would be recommended in patients with AS. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.http://www.sciencedirect.com/science/article/pii/S2666914525000934Retinal vascular occlusive diseaseEpidemiologyAortic stenosisVascular stiffness
spellingShingle Minjeong Kim, MD
Eui-Young Choi, MD, PhD
Kunho Bae, MD
Ju-Yeun Lee, MD, PhD
Risk of Retinal Vascular Occlusive Disease in Patients with Aortic Stenosis
Ophthalmology Science
Retinal vascular occlusive disease
Epidemiology
Aortic stenosis
Vascular stiffness
title Risk of Retinal Vascular Occlusive Disease in Patients with Aortic Stenosis
title_full Risk of Retinal Vascular Occlusive Disease in Patients with Aortic Stenosis
title_fullStr Risk of Retinal Vascular Occlusive Disease in Patients with Aortic Stenosis
title_full_unstemmed Risk of Retinal Vascular Occlusive Disease in Patients with Aortic Stenosis
title_short Risk of Retinal Vascular Occlusive Disease in Patients with Aortic Stenosis
title_sort risk of retinal vascular occlusive disease in patients with aortic stenosis
topic Retinal vascular occlusive disease
Epidemiology
Aortic stenosis
Vascular stiffness
url http://www.sciencedirect.com/science/article/pii/S2666914525000934
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