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Risk factors associated with developing branch retinal vein occlusion among enrollees in a United States managed care plan.

ABSTRACT: To determine risk factors associated with development of a branch retinal vein occlusion (BRVO) among a large group of managed-care plan beneficiaries in the United States.Retrospective, longitudinal cohort study.All beneficiaries age ?55 years continuously enrolled for ?2 years in a managed care network from 2001-2009 who had ?2 visits to an eye care provider.Multivariable Cox regression analyses identified sociodemographic factors, ocular and nonocular conditions associated with incident BRVO.Hazard of incident BRVO with 95% confidence interval (CI).Of the 492,488 enrollees who met inclusion criteria, 2283 (0.5%) developed incident BRVO. After adjustment for confounding factors, blacks (adjusted hazard ratio [aHR], 1.43; CI, 1.19-1.73; P = 0.0001) had a 43% increased hazard of BRVO relative to non-Hispanic whites. Enrollees with hypertension (HTN) alone (aHR, 1.78; CI, 1.36-2.32; P??0.10 for all comparisons).Both HTN and end-organ damage from DM contribute to arteriosclerosis, atherosclerosis, and endothelial dysfunction, which seem to be major risk factors for BRVO. Ophthalmologists should emphasize to patients and their primary physicians the importance of effectively managing systemic medical conditions associated with BRVO.

SUBMITTER: Newman-Casey PA

PROVIDER: S-EPMC4177949 | biostudies-literature | 2014 Oct

REPOSITORIES: biostudies-literature

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Risk factors associated with developing branch retinal vein occlusion among enrollees in a United States managed care plan.

Newman-Casey Paula Anne PA Stem Maxwell M Talwar Nidhi N Musch David C DC Besirli Cagri G CG Stein Joshua D JD

Ophthalmology 20140620 10

<h4>Purpose</h4>To determine risk factors associated with development of a branch retinal vein occlusion (BRVO) among a large group of managed-care plan beneficiaries in the United States.<h4>Design</h4>Retrospective, longitudinal cohort study.<h4>Participants</h4>All beneficiaries age ≥55 years continuously enrolled for ≥2 years in a managed care network from 2001-2009 who had ≥2 visits to an eye care provider.<h4>Methods</h4>Multivariable Cox regression analyses identified sociodemographic fac ...[more]

PMID: 24953793

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Project description:BackgroundTo study the changes of retinal vascular density (VD), retinal thickness (RT), and their correlations with visual acuity (VA) in branch retinal vein occlusion (BRVO) patients with retinal atrophy after resolution of macular oedema (MO).MethodsThis is a retrospective study consisting of 46 patients diagnosed with BRVO at Beijing Hospital from 2015 to 2019. Patients' 46 affected eyes and 39 fellow eyes were included. The affected eyes were further divided into the atrophy group and the nonatrophy group. Optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) images obtained when MO completely resolved after treatment with ranibizumab were analyzed. We quantitatively measured foveal avascular zone (FAZ) parameters, the disruption extent of ellipsoid zone (EZ), RT, and VD of superficial vascular complex (SVC), and deep vascular complex (DVC) in central fovea and the minimal-VD quadrant. Paired t-tests, independent t-tests, Mann-Whitney U tests, Wilcoxon tests, Pearson correlation analyses, Spearman correlation analyses, and single and multiple linear regression models were adopted.ResultsCompared with nonatrophy eyes, the minimal-VD quadrantal (quadrantal for short) SVC-VD (25.76 ± 4.57% versus 36.21 ± 6.47%, P < 0.001) and quadrantal DVC-VD (27.72 (17.23) % versus 38.95 (11.05) %, P = 0.001) of atrophy eyes decreased significantly. Quadrantal SVC-VD and quadrantal DVC-VD were strongly correlated with quadrantal full RT (r = 0.763 and 0.698, both P < 0.001). The disruption length of EZ was significantly correlated with quadrantal full RT (r = -0.406, P = 0.005) and quadrantal SVC-VD (r = -0.298, P = 0.044). In multiple linear regression analysis, the disruption length of EZ and VA before treatment and age showed significant correlations with VA with complete resolution of MO (P = 0.020, 0.033, and 0.002).ConclusionsThe retinal VD on the affected area correlates well with the corresponding full RT when BRVO-MO completely resolves, suggesting that VD may predict the final RT. Severe decrease in VD may result in retinal atrophy, which may cause VA loss indirectly with the intermediate influencing factor of EZ defects.

Dataset Information

Risk factors associated with developing branch retinal vein occlusion among enrollees in a United States managed care plan.

Publications

Risk factors associated with developing branch retinal vein occlusion among enrollees in a United States managed care plan.

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