Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA; State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China.
Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA; Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA.
Ophthalmol Retina. 2022 Feb;6(2):161-171. doi: 10.1016/j.oret.2021.05.004. Epub 2021 May 12.
Retinal vascular occlusion is a leading cause of profound irreversible visual loss, but the understanding of the disease is insufficient. We systematically investigated the age, gender, and laterality at the onset of retinal artery occlusion (RAO) and retinal vein occlusion (RVO) in the Intelligent Research in Sight (IRIS®) Registry.
Retrospective registry cohort.
Patients with retinal vascular occlusion participating in the IRIS® Registry.
Patients who received a diagnosis of retinal vascular occlusion between 2013 and 2017 were included. Those with unspecified gender or laterality were excluded when conducting the relevant analyses. Patients were categorized into RAO, with subtypes transient retinal artery occlusion (TRAO), partial retinal artery occlusion (PRAO), branch retinal artery occlusion (BRAO), and central retinal artery occlusion (CRAO), and into RVO, with subtypes venous engorgement (VE), branch retinal vein occlusion (BRVO), and central retinal vein occlusion (CRVO). Age was evaluated as a categorical variable (5-year increments). We investigated the association of age, gender, and laterality with the onset frequency of retinal vascular occlusion subtypes.
The frequency of onset of RAO and RVO subtypes by age, gender and laterality.
A total of 1 251 476 patients with retinal vascular occlusion were included, 23.8% of whom had RAO, whereas 76.2% had RVO. Of these, 1 248 656 and 798 089 patients were selected for analyses relevant to gender and laterality, respectively. The onset frequency of all subtypes increased with age. PRAO, BRAO, CRAO, and CRVO presented more frequently in men (53.5%, 51.3%, 52.6%, and 50.4%, respectively), whereas TRAO, VE, and BRVO presented more frequently in women (54.9%, 56.0%, and 54.5% respectively). All RAO subtypes and BRVO showed a right-eye onset preference (TRAO, 51.7%; PRAO, 54.4%; BRAO, 53.5%; CRAO, 53.4%; and BRVO, 51.0%), whereas VE and CRVO exhibited a left-eye onset preference (53.3% and 50.9%, respectively).
Although retinal vascular occlusion incidence increases with age regardless of subtypes, we found various subtype-specific disease-onset differences related to gender and, in particular, ocular laterality. These findings may improve understanding of the specific cause of retinal vascular occlusions of different subtypes and their relationships with structural and anatomic asymmetries of the vascular system.
视网膜血管阻塞是导致严重不可逆视力丧失的主要原因，但对该疾病的认识还不够充分。我们通过智能视野研究（IRIS®）注册系统，系统地研究了视网膜动脉阻塞（RAO）和视网膜静脉阻塞（RVO）的发病年龄、性别和侧别。
回顾性注册队列研究。
参与 IRIS®注册的视网膜血管阻塞患者。
纳入 2013 年至 2017 年期间诊断为视网膜血管阻塞的患者。在进行相关分析时，排除了性别或侧别未明确的患者。将患者分为 RAO，包括短暂性视网膜动脉阻塞（TRAO）、部分性视网膜动脉阻塞（PRAO）、分支性视网膜动脉阻塞（BRAO）和中央性视网膜动脉阻塞（CRAO），以及 RVO，包括静脉淤血（VE）、分支性视网膜静脉阻塞（BRVO）和中央性视网膜静脉阻塞（CRVO）。年龄评估为分类变量（每 5 年一个阶段）。我们研究了年龄、性别和侧别与视网膜血管阻塞亚型发病频率的关系。
按年龄、性别和侧别划分的 RAO 和 RVO 亚型发病频率。
共纳入 1251476 例视网膜血管阻塞患者，其中 23.8%为 RAO，76.2%为 RVO。其中，1248656 例和 798089 例患者分别用于分析性别和侧别相关的发病情况。所有亚型的发病频率均随年龄增长而增加。PRAO、BRAO、CRAO 和 CRVO 更常见于男性（分别为 53.5%、51.3%、52.6%和 50.4%），而 TRAO、VE 和 BRVO 更常见于女性（分别为 54.9%、56.0%和 54.5%）。所有 RAO 亚型和 BRVO 均表现出右眼发病优势（TRAO 为 51.7%；PRAO 为 54.4%；BRAO 为 53.5%；CRAO 为 53.4%；BRVO 为 51.0%），而 VE 和 CRVO 则表现出左眼发病优势（分别为 53.3%和 50.9%）。
尽管无论亚型如何，视网膜血管阻塞的发病率都随年龄增长而增加，但我们发现了与性别，尤其是眼别有关的各种亚型特异性疾病发病差异。这些发现可能有助于提高对不同亚型视网膜血管阻塞的具体病因及其与血管系统结构和解剖不对称性之间关系的认识。
