Hwang Daniel Duck-Jin, Lee Kyung-Eun, Kim Yuwon, Kim Myoung-Suk, Rim Tyler Hyungtaek, Kim Mina, Kim Hasung, Kyoung Dae-Sung, Park Ji In
Department of Ophthalmology, Hangil Eye Hospital, Incheon, Korea.
Department of Ophthalmology, Catholic Kwandong University College of Medicine, Incheon, Korea.
JAMA Netw Open. 2023 Mar 1;6(3):e233068. doi: 10.1001/jamanetworkopen.2023.3068.
It remains unclear whether comorbidities in patients with retinal artery occlusion (RAO), a rare retinal vascular disorder, differ by subtype and whether mortality is higher.
To examine the nationwide incidence of clinically diagnosed, nonarteritic RAO, causes of death, and mortality rate in patients with RAO compared with that in the general population in Korea.
DESIGN, SETTING, AND PARTICIPANTS: This retrospective, population-based cohort study examined National Health Insurance Service claims data from 2002 to 2018. The population of South Korea was 49 705 663, according to the 2015 census. Data were analyzed from February 9, 2021, to July 30, 2022.
The nationwide incidence of any RAO, including central RAO (CRAO; International Statistical Classification of Diseases and Related Health Problems, Tenth Revision [ICD-10] code, H34.1) and noncentral RAO (other RAO; ICD-10 code, H34.2) was estimated using National Health Insurance Service claims data from 2002 to 2018, with 2002 to 2004 as the washout period. Furthermore, the causes of death were evaluated and the standardized mortality ratio was estimated. The primary outcomes were the incidence of RAO per 100 000 person-years and the standardized mortality ratio (SMR).
A total of 51 326 patients with RAO were identified (28 857 [56.2%] men; mean [SD] age at index date: 63.6 [14.1] years). The nationwide incidence of any RAO was 7.38 (95% CI, 7.32-7.44) per 100 000 person-years. The incidence rate of noncentral RAO was 5.12 (95% CI, 5.07-5.18), more than twice that of CRAO (2.25 [95% CI, 2.22-2.29]). Mortality was higher in patients with any RAO than in the general population (SMR, 7.33 [95% CI, 7.15-7.50]). The SMR for CRAO (9.95 [95% CI, 9.61-10.29]) and for noncentral RAO (5.97 [95% CI, 5.78-6.16]) showed a tendency toward a gradual decrease with increasing age. The top 3 causes of death in patients with RAO were diseases of the circulatory system (28.8%), neoplasms (25.1%), and diseases of the respiratory system (10.2%).
This cohort study found that the incidence rate of noncentral RAO was higher than that of CRAO, whereas SMR was higher for CRAO than noncentral RAO. Patients with RAO show higher mortality than the general population, with circulatory system disease as the leading cause of death. These findings suggest that it is necessary to investigate the risk of cardiovascular or cerebrovascular disease in patients newly diagnosed with RAO.
视网膜动脉阻塞（RAO）是一种罕见的视网膜血管疾病，目前尚不清楚其合并症是否因亚型而异，以及死亡率是否更高。
研究韩国临床诊断的非动脉性RAO的全国发病率、死亡原因以及与普通人群相比RAO患者的死亡率。
设计、背景和参与者：这项基于人群的回顾性队列研究分析了2002年至2018年的国民健康保险服务索赔数据。根据2015年人口普查，韩国人口为49705663人。数据于2021年2月9日至2022年7月30日进行分析。
利用2002年至2018年国民健康保险服务索赔数据估计任何RAO（包括中央视网膜动脉阻塞（CRAO；国际疾病分类及相关健康问题第十次修订版[ICD-10]编码，H34.1）和非中央视网膜动脉阻塞（其他RAO；ICD-10编码，H34.2）的全国发病率，以2002年至2004年为洗脱期。此外，评估死亡原因并估计标准化死亡率。主要结局是每10万人年的RAO发病率和标准化死亡率（SMR）。
共识别出51326例RAO患者（28857例[56.2%]为男性；索引日期时的平均[标准差]年龄：63.6[14.1]岁）。任何RAO的全国发病率为每10万人年7.38（95%CI，7.32-7.44）。非中央RAO的发病率为5.12（95%CI，5.07-5.18），是CRAO（2.25[95%CI，2.22-2.29]）的两倍多。任何RAO患者的死亡率均高于普通人群（SMR，7.33[95%CI，7.15-7.50]）。CRAO（9.95[95%CI，9.61-10.29]）和非中央RAO（5.97[95%CI，5.78-6.16]）的SMR均显示出随年龄增长逐渐下降的趋势。RAO患者的前三大死亡原因是循环系统疾病（28.8%）、肿瘤（25.1%）和呼吸系统疾病（10.2%）。
这项队列研究发现，非中央RAO的发病率高于CRAO，而CRAO的SMR高于非中央RAO。RAO患者的死亡率高于普通人群，循环系统疾病是主要死亡原因。这些发现表明，有必要对新诊断为RAO的患者进行心血管或脑血管疾病风险的调查。
