Nine year follow-up study of morbidity and mortality in retinal vein occlusion

Purpose The aim of this study was to conduct a detailed retrospective follo w-up of a large cohort of patients with retinal vein occlusion (RVO), exami ning morbidity and mortality, to investigate a possible relationship betwee n RVO, large vessel disease and stroke, and to determine whether recurrence of RVO was influenced by treatment of associated medical conditions. Methods A follow-up study was undertaken in 1994 of all patients (n = 588) who presented to the medical ophthalmology clinics of the Birmingham and Mi dland Eye Hospital between 1982 and 1989 with a definitive diagnosis of RVO . Results Follow-up data were obtained on 549 patients (93%). Results showed that recurrence of RVO in the same or fellow eye was decreased by more than half in the follow-up group (3.3%) when compared with the known recurrence rate at initial presentation (8.8%). Comparison of the deceased with the s urvivors showed that the deceased patients were significantly older (mean a ge 70.2 vs 63.4 years). The prevalence of rubeosis iridis and smoking were statistically significantly increased when comparing the deceased with the survivors (p < 0.016 and p < 0.008 respectively). The deceased had a higher prevalence of diabetes (15.8% vs 10.1%), and there was a trend towards inc reased clinically evident macrovascular disease in those patients who had d ied (23.2% vs 19.5%). Neither hypertension nor hyperlipidaemia predicted de ath, as the prevalence rates of the two conditions were similar in survivor s and those who had died (60.0% vs 60.6% and 48.4% vs 53.3%). The percentag e of patients taking antiplatelet drug therapy was not different in the two groups (36.8% vs 38.3%). Analysis of the causes of death of the RVO popula tion (n = 95) compared with the causes of death in the West Midlands popula tion as a whole, showed that the percentage of deaths from myocardial infar ction in the RVO population was significantly higher (23.1% vs 14.4%, p < 0 .05). There was no statistical difference between the populations for ischa emic heart disease and stroke, although there was a trend for increased mor tality from stroke (19% vs 13.5%). Conclusion These data suggest a relationship between RVO, mortality and inc reased cardiovascular risk factors (smoking, diabetes and macrovascular dis ease), and support the possibility of an association between RVO and stroke . They also support the potential value of medical treatment of underlying medical conditions in preventing recurrence of RVO.