Retinal Vein Occlusion in Patients 55 and Younger with Migraine: A Comparative Outcomes Analysis.

PURPOSE: To evaluate the risk of retinal vein occlusion (RVO) in patients 55 years old or younger with a history of migraine compared to a control group without migraine. METHODS: Using the TriNetX platform, a retrospective cohort analysis was conducted comparing patients 55 or younger with a diagnosis of migraine to non-migraine patients undergoing routine health exams. The study period comprised 20 years from March 2006 through March 2026. 1:1 nearest-neighbor propensity score matching without replacement was used to balance baseline demographics, BMI, and comorbidities between cohorts. RVO incidence was the primary outcome measure, including central (CRVO) and branch (BRVO) subtypes, defined by ICD-10 codes. RESULTS: After propensity score matching, the combined matched sample comprised 3,482,652 individuals (1,741,326 per cohort). RVO (composite): 462 events in the migraine cohort vs 325 events in the control cohort (RR = 1.422, 95% CI: 1.234-1.638; p < 0.001; HR = 1.331, 95% CI: 1.155-1.534; log-rank χ2 = 15.655; p < 0.001). CRVO: 303 vs 206 events (RR = 1.471, 95% CI: 1.232-1.756; p < 0.001; HR = 1.375, 95% CI: 1.152-1.641; log-rank χ2 = 12.511; p < 0.001). BRVO: 221 vs 154 events (RR = 1.435, 95% CI: 1.168-1.763; p = 0.001; HR = 1.340, 95% CI: 1.090-1.646; log-rank χ2 = 7.798; p = 0.005). CONCLUSION: Patients ≤55 years old with a history of migraine have an increased risk of developing retinal vein occlusion compared to controls without migraines.