Clausen Anna Rebien, Stokholm Lonny, Blaabjerg Morten, Frederiksen Katrine Hartmund, Pedersen Frederik Nørregaard, Grauslund Jakob
Department of Ophthalmology, Odense University Hospital, Kløvervaenget 5, Odense, 5000, Denmark.
Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
Int J Retina Vitreous. 2023 Aug 29;9(1):50. doi: 10.1186/s40942-023-00488-3.
Retinal artery occlusion (RAO) is a vision threatening disease associated with cerebral vascular dysfunction, which may reflect initial signs of cerebral pathology. Early detection of patients in risk of dementia could allow for preventative treatment. Hence, this study aimed to investigate RAO as an independent biomarker of incident dementia.
This study was a nationwide, 20-year longitudinal cohort study in Denmark with inclusion from 1998 to 2020 and follow up until the end of 2022. We identified 2 205 159 individuals aged 65 or older through the Danish national health registers and monitored RAO (exposure) and dementia (outcome) status. We calculated incidence rate and performed a Cox regression analysis with hazard ratio (HR) and 95% confidence interval (CI) for RAO as a marker of dementia in a crude, a semi-adjusted (age and sex), and a fully adjusted model (furthermore adjusted for marital status and systemic comorbidity.) RESULTS: We identified 8 863 individuals with RAO. Incidence rates were higher among exposed compared to unexposed individuals (12.28 and 8.18 per 1000 person-years at risk, respectively). Individuals with RAO were more likely to be male and older at inclusion, to have hypertension, dyslipidaemia, cardiovascular disease, chronic kidney disease, and diabetes (p < 0.001). RAO was not associated with all-cause dementia in the crude analysis (HR 1.07 CI [1.00-1.17]) or in the fully adjusted analysis (HR 0.98 CI [0.91-1.06].
Although individuals with RAO had a higher incidence of dementia compared to unexposed individuals, these associations were lost when confounders were taken into account.
视网膜动脉阻塞（RAO）是一种与脑血管功能障碍相关的威胁视力的疾病，这可能反映出脑部病变的初始迹象。早期发现有患痴呆症风险的患者可进行预防性治疗。因此，本研究旨在调查RAO作为新发痴呆症的独立生物标志物。
本研究是一项在丹麦进行的全国性、为期20年的纵向队列研究，纳入时间为1998年至2020年，随访至2022年底。我们通过丹麦国家健康登记册确定了2205159名65岁及以上的个体，并监测了RAO（暴露因素）和痴呆症（结局）状态。我们计算了发病率，并在粗模型、半调整模型（年龄和性别）和全调整模型（进一步调整婚姻状况和全身合并症）中进行了Cox回归分析，以RAO作为痴呆症的标志物，计算风险比（HR）和95%置信区间（CI）。结果：我们确定了8863名患有RAO的个体。暴露个体的发病率高于未暴露个体（分别为每1000人年12.28例和8.18例）。患有RAO的个体在纳入时更可能为男性且年龄较大，患有高血压、血脂异常、心血管疾病、慢性肾脏病和糖尿病（p<0.001）。在粗分析（HR 1.07，CI[1.00-1.17]）或全调整分析（HR 0.98，CI[0.91-1.06]）中，RAO与全因痴呆症无关。
尽管患有RAO的个体与未暴露个体相比痴呆症发病率更高，但在考虑混杂因素后，这些关联消失了。
