Traditional and Novel Cardiovascular Risk Factors for Retinal Vein Occlusion: The Multiethnic Study of Atherosclerosis

PURPOSE: To describe the prevalence of retinal vein occlusion (RVO) and its association with cardiovascular, inflammatory, and hematologic risk factors in a multiethnic cohort. METHODS: This was a population-based, cross-sectional study of 6147 participants (whites, blacks, Hispanics, Chinese) from six U.S. communities. RVO was defined from retinal photographs taken from both eyes according to a standardized protocol. Risk factors were assessed from interviews, examinations, and laboratory and radiologic investigations. RESULTS: The prevalence of RVO was 1.1% (0.9% for branch RVO and 0.2% for central RVO) and was similar across different ethnic groups: 0.9% in whites, 1.2% in blacks, 1.2% in Hispanics, and 1.1% in Chinese (P = 0.76). Independent risk factors associated with RVO were hypertension (odds ratio OR, 2.06; 95% confidence interval CI, 1.18-3.59), older age (OR, 1.34; 95% CI, 1.00-1.81, per decade increase), less education (OR, 4.08; 95% CI, 2.20-7.54), hypertriglyceridemia (OR, 1.98; 95% CI, 1.10-3.56), renal dysfunction (OR, 1.85; 95% CI, 1.01-3.39), and the presence of retinal arteriovenous nicking (OR, 4.01; 95% CI, 2.06-7.81) and focal arteriolar narrowing (OR, 4.38; 95% CI, 1.44-13.34). RVO was not significantly associated with direct measures of subclinical atherosclerosis (e.g., carotid intima media thickness and coronary artery calcium scores) or markers of inflammation (e.g., C reactive protein, interleukin-6) and endothelial dysfunction (e.g., soluble intercellular adhesion molecule-1) or coagulation (e.g., D-dimer). CONCLUSIONS: The prevalence of RVO is similar across different racial/ethnic groups. In the general population, RVO is associated with hypertension, dyslipidemia, and renal dysfunction, but not with atherosclerotic disease, systemic inflammation, and hematologic abnormalities.