Incidence of retinal vein occlusion and its association with mortality : results from the Gutenberg Health Study

Abstract

Purpose To determine the incidence of retinal vein occlusion (RVO) in the general population in Germany and analyze potential associations with ocular and systemic factors as well as with mortality. Design Analysis of a prospective population-based cohort study. Participants The Gutenberg Health Study is a population-based cohort study, including 15 010 participants 35 to 74 years of age. A total of 12 954 participants were included with a gradable fundus photograph at baseline. A total of 9305 participants at the 5-year-follow-up and 6428 participants at 10-year-follow-up had additional images. Methods At baseline and the 5- and 10-year follow-up examinations, fundus photographs of the macula and the optic disc were obtained. At the 5- and 10-year follow-up, infrared images also were obtained. We evaluated these for RVO (branch RVO [BRVO] and central RVO [CRVO]). The cumulative 5-year- and 10-year–incidence was computed on a per-person level. Multivariable logistic regression analysis was conducted to assess associated factors and cox regression was performed to analyze its influence on mortality. Main Outcome Measures Five-year and 10-year cumulative incidence of BRVO and CRVO. Results The 5-year-cumulative-incidence was 0.35% (95% confidence interval [CI], 0.25%–0.5%; n = 33) for BRVO and 0.043% (95% CI, 0.014-0.12%; n = 4) for CRVO. The 10-year cumulative incidence was 0.64% (95% CI, 0.46%–0.87%; n = 55) for BRVO and 0.14% (95% CI, 0.067%–0.27%; n = 12) for CRVO. Incidence of RVO was associated with older age (odds ratio, 1.05; 95% CI, 1.02–1.09; P < 0.001). An increased risk of mortality was noted in patients with RVO (BRVO: hazard ratio, 2.27; 95% CI, 1.08–3.0; P = 0.023; CRVO: hazard ratio, 3.83; 95% CI, 1.95–7.9; P < 0.001) after adjustment for cardiovascular risk factors. Conclusions This study described the incidence of RVO in a large European population–based cohort and is associated with an increased mortality after RVO. Financial Disclosure(s) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.