Association between retinal vein occlusion and risk of heart failure: A 12-year nationwide cohort study

Backgrounds Retinal vein occlusion (RVO) is one of the major causes of visual impairment in elderly people. Risk factors for RVO are also common risk factors for cardiovascular disease, including heart failure (HF). However, the association between RVO and HF has not been evaluated. Methods and results A retrospective propensity-score matched cohort study was conducted using national representative 1 million samples from the Korea National Health Insurance Service. The RVO group included patients with a first diagnosis of either central or branch RVO (n = 1754) and the comparison group included randomly selected patients (n = 8749) who were matched to sociodemographic factors and the year of RVO diagnosis. In the longitudinal cohort, HF developed in 11.6% and 8.0% of patients in the RVO and comparison groups, respectively, (p < 0.001) during the 11-year follow-up period (median, 7.6 years). RVO was significantly associated with an increased risk of HF after multivariable adjustment (HR = 1.36; 95% CI, 1.16-1.60). In terms of HF subtypes, RVO was associated with the risk of ischemic HF but not with the risk of non-ischemic HF. The effect size (~ HR) for HF by RVO was larger in patients without each comorbidity than in patients with each comorbidity. Conclusions Our observational study on nationwide data suggests that RVO is associated with an increased risk of the incidence of HF, especially ischemic HF. An optimal surveillance strategy and referring from ophthalmologists to cardiologists should be considered in the presence of one or more additional HF risk factors in patients with RVO.