![]() ![]() ICD-8 codes were used from 1974 to 1995, and ICD-10 codes from 1996 onwards. Furthermore, independent subgroup analyses were performed for RAO and RVO.ĭata was collected from the following Danish nationwide registers: The Danish National Patient Register contains information regarding all hospital admissions since 1974 classified by diagnoses according to International Classification of Diseases (ICD). To explore these associations, we identified all new cases of retinal vascular occlusion in patients without prior AF in Denmark between 19 in a nationwide cohort study. RAO or RVO) overall would be associated with increased risk of incident AF. We hypothesized that in patients without previously known AF, retinal vascular occlusions (i.e. Accordingly, retinal vascular occlusion in patients with AF may merit treatment with anticoagulation. We have previously shown that retinal vascular occlusion independently increases the risk of ischemic stroke and thromboembolism in patients with AF. Guidelines recommend treatment with anticoagulation to decrease the risk of ischemic stroke in patients with AF according to the CHA 2DS 2-VASc (congestive heart failure, hypertension, age > 75 years, diabetes, stroke, vascular disease, age 65–75 and female sex score). As AF is often asymptomatic, subclinical (silent) AF could represent the underlying cause in RAO patients without known AF, While it has been argued that embolisms arising in the atria are too large to cause RAO, valvular heart disease, as well as AF, may be risk factors for RAO. RAO or RVO) should include a careful evaluation of cardiovascular risk factors. This definition of ischemic stroke applies to current guidelines, and implies that the work-up of patients with retinal vascular occlusions (i.e. Ischemic stroke is an episode of neurological dysfunction caused by focal cerebral, spinal, or retinal infarction. Similarly, patients with RAO and RVO are at increased risk of thrombosis-related complications such as myocardial infarction and stroke as well as silent brain infarction. Both conditions are associated with cardiovascular risk factors, such as hypertension and diabetes mellitus. The embolic source in patients with RAO is thought to be the carotid artery or valvular disease, but patients with AF are at increased risk of developing RAO. Atrial fibrillation (AF) is not included amongst the known risk factors for RVO. The pathogenesis of RVO is mainly considered to be thrombus formation, whereas embolisms result in RAO. Retinal artery and vein occlusions (RAO and RVO) are common causes of retinal vascular disease. Awareness of AF in patients with retinal vascular occlusions is advised. ConclusionsĪ new diagnosis of retinal vascular occlusion in patients without prior AF was associated with increased risk of incident AF, particularly amongst patients with RAO. The rate of incident AF amongst all cases with retinal vascular occlusion was 1.74 per 100 person-years (95% confidence interval (CI), 1.47–2.06) compared to 1.22 (95% CI, 1.12–1.33) in the matched control group. One thousand three hundred sixty-eight cases with retinal vascular occlusions were identified (median age 71.4 (inter quartile range (IQR) 61.2–79.8), 47.3% male). Hazard ratios (HR) of AF according to retinal vascular occlusion were adjusted for hypertension, diabetes, vascular disease and prior stroke/systemic thromboembolism/transient ischemic attack. Cumulative incidence and unadjusted rates of AF according to retinal vascular occlusions (i.e. Patients with retinal occlusions from 1997 to 2011 were identified through Danish nationwide registries and matched 1:5 according to sex and age. To shed light on this association, we investigated the risk of new onset AF in patients with known RAO and RVO. It is unknown if a presentation of retinal artery or venous occlusions may indicate a new onset cardiac arrhythmia. The inter-relationships of atrial fibrillation (AF) to retinal vascular occlusions (whether retinal artery occlusion (RAO) or retinal venous occlusion (RVO)) remain unclear. ![]()
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