Department of Ophthalmology, Chi Mei Medical Center, Tainan, Taiwan; Graduate Institute of Medical Sciences, College of Health Sciences, Chang Jung Christian University, Tainan, Taiwan.
Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan; Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
Diabetes Res Clin Pract. 2021 Jan;171:108607. doi: 10.1016/j.diabres.2020.108607. Epub 2020 Dec 9.
To investigate the risk of retinal vein occlusion (RVO) in new-onset diabetes mellitus (DM) patients.
This nationwide, retrospective, matched cohort study included 240,761 DM patients registered between January 2003 and December 2005 in the Longitudinal Cohort of Diabetes Patients database. An age- and sex-matched control group comprising 240,761 non-DM patients (case: control = 1:1) was selected from the Taiwan Longitudinal Health Insurance Database 2000. Information for each patient from the index date until December 2013 was collected. The incidence and risk of RVO were compared between the two groups. Cox proportional hazard regression analysis was performed to calculate the adjusted hazard ratio (HR) for RVO after adjustment for potential confounders. The RVO cumulative incidence rate was obtained using Kaplan-Meier analysis.
During the follow-up period, 1,456 DM patients developed RVO (491, central retinal vein occlusion; 965, branch retinal vein occlusion). There was a significantly elevated risk of RVO in DM patients compared with the controls (incidence rate ratio = 1.91, 95% confidence interval [CI] = 1.75-2.08). Patients with DM showed significant risk of RVO after adjustment for potential confounders (hypertension, hyperlipidemia, congestive heart failure, coronary artery disease, and chronic renal disease) in the full cohort (adjusted HR = 1.76, 95% CI = 1.61-1.93). Additionally, patients with hypertension had a significantly higher risk of RVO than patients without hypertension after adjustment for other confounders in the cohort (adjusted HR = 1.50, 95% CI = 1.36-1.65).
We found that patients with DM have increased risks of RVO. In addition to blood pressure control, we recommend educating patients with DM about RVO, to prevent its subsequent occurrence.
探讨初发糖尿病（DM）患者发生视网膜静脉阻塞（RVO）的风险。
本项全国性、回顾性、匹配队列研究纳入了 2003 年 1 月至 2005 年 12 月期间在糖尿病患者纵向队列数据库中登记的 240761 例 DM 患者。从台湾 2000 年纵向健康保险数据库中选择了年龄和性别与之匹配的 240761 例非 DM 患者（病例：对照=1：1）作为对照组。收集每位患者自索引日期至 2013 年 12 月的信息。比较两组患者的 RVO 发生率和风险。采用 Cox 比例风险回归分析计算潜在混杂因素校正后的 RVO 调整后风险比（HR）。采用 Kaplan-Meier 分析获得 RVO 累积发生率。
在随访期间，1456 例 DM 患者发生 RVO（491 例为中央视网膜静脉阻塞，965 例为分支视网膜静脉阻塞）。与对照组相比，DM 患者发生 RVO 的风险显著升高（发生率比=1.91，95%置信区间[CI]：1.75-2.08）。在全队列中，校正潜在混杂因素（高血压、高血脂、充血性心力衰竭、冠心病和慢性肾病）后，DM 患者发生 RVO 的风险显著增加（校正 HR=1.76，95%CI：1.61-1.93）。此外，在校正其他混杂因素后，高血压患者发生 RVO 的风险明显高于无高血压患者（校正 HR=1.50，95%CI：1.36-1.65）。
我们发现 DM 患者发生 RVO 的风险增加。除了控制血压外，我们还建议向 DM 患者宣传 RVO，以预防其发生。
