Retinal artery occlusion predicts macrovascular complications in patients with diabetes

Individuals with diabetes who have been diagnosed with retinal artery occlusion (RAO) are at greater risk of macrovascular complications for at least 5 years following the occlusion event relative to those with no RAO, a study has found.

A team of investigators retrieved data from 992 individuals with incident RAO and pre-existing diabetes, registered in Denmark between 1 January 2000 and 31 December 2018. They then matched each RAO patient for age, sex, and diabetes duration with five control participants with diabetes but without RAO.

Finally, survival analyses were conducted to compare the risk of extraocular macrovascular disease between the two groups in a 5-year follow-up.

One-year incidence of macrovascular disease in patients with RAO was about 21 per 100 person-years (95 percent confidence interval [CI], 18.11‒24.29) compared to just 6.25 per 100 person-years (95 percent CI, 5.57‒7.00) in those without RAO.

The cumulative incidences of macrovascular disease at 5 years were 51.2 percent (95 percent CI, 47.9‒54.7) in patients with diabetes and RAO and 29.4 percent (95 percent CI, 28.0‒30.8) in those with diabetes but without RAO. Hazard ratios were 3.36 (95 percent CI, 2.79‒4.05) and 2.27 (95 percent CI, 2.04‒2.53) after 1 year and 5 years, respectively.

“A characteristic of the retinal circulation is that arterial occlusion is embolic or secondary to vasculitis but rarely or never due to in situ atherosclerosis,” the investigators said. “Therefore, RAO suggests the presence of cardiac or large-vessel disease outside the eye.”