ytemic dieae aociated with variou type of retinal vein occluion

PURPOE: To invetigate ytemic dieae aociated with variou type of retinal vein occluion. METHOD: We invetigated propectively in 1090 conecutive patient with retinal vein occluion, almot all Caucaian (conitent with the racial pattern here), the prevalence of aociated ytemic diorder before or at the onet of variou type of retinal vein occluion. The patient were categorized into ix type of retinal vein occluion baed on defined criteria: nonichemic and ichemic central retinal vein occluion, nonichemic and ichemic hemi-central retinal vein occluion, and major and macular branch retinal vein occluion. The patient had a detailed ophthalmic and ytemic evaluation according to our protocol. For data analyi, patient were divided into three age group: young (younger than 45 year), middle-aged (45 to 64 year), and elderly (65 year or older). The oberved prevalence rate of major ytemic dieae were compared among central retinal vein occluion, hemi-central retinal vein occluion, and branch retinal vein occluion uing a polytomou logitic regreion analyi adjuting for gender and age. Logitic regreion adjuting for age and gender wa alo ued to compare the oberved prevalence of ytemic dieae between nonichemic and ichemic in central retinal vein occluion and hemi-central retinal vein occluion and between major and macular branch retinal vein occluion. Thee oberved prevalence rate were alo compared with thoe expected in a gender-matched and age-matched control population from etimate from the U National Center for Health tatitic. REULT: There wa a ignificantly higher prevalence of arterial hypertenion in branch retinal vein occluion compared with central retinal vein occluion (P < .0001) and hemi-central retinal vein occluion (P = .028). Branch retinal vein occluion alo had a ignificantly higher prevalence of peripheral vacular dieae (P = .0002), venou dieae (P = .011), peptic ulcer (P = .031), and other gatrointetinal dieae (P < .0001) compared with central retinal vein occluion. The proportion of patient with branch retinal vein occluion with cerebrovacular dieae wa alo ignificantly (P = .049) greater than that of the combined group of patient with central retinal vein occluion and patient with hemi-central retinal vein occluion. There wa no ignificant difference in prevalence of any ytemic dieae between central retinal vein occluion and hemi-central retinal vein occluion. A ignificantly greater prevalence of arterial hypertenion (P = .025) and diabete mellitu (P = .011) wa preent in the ichemic central retinal vein occluion compared with the nonichemic central retinal vein occluion. imilarly, arterial hypertenion (P = .0002) and ichemic heart dieae (P = .048) were more prevalent in major branch retinal vein occluion than in macular branch retinal vein occluion. Relative to the U white control population, the combined group of patient with central retinal vein occluion and patient with hemi-central retinal vein occluion had a higher prevalence of arterial hypertenion (P < .0001), peptic ulcer (P < .0001), diabete mellitu (in ichemic type only, P < .0001), and thyroid diorder (P < .0001). The patient with branch retinal vein occluion howed a greater prevalence of arterial hypertenion (P ≤ .005), cerebrovacular dieae (P = .007), chronic obtructive pulmonary dieae (P = .012), peptic ulcer (P < .0001), diabete (in young only, P = .0005), and thyroid diorder (P = .003) compared with the U white control population. CONCLUION: The finding of our tudy revealed that a variety of ytemic diorder may be preent in aociation with different type of retinal vein occluion and in different age group, and that their relative prevalence differ ignificantly, o that the common practice of generalizing about thee diorder for the entire group of patient with retinal vein occluion can be mileading. The preence of a particular aociated ytemic dieae doe not necearily imply a caue-and-effect relationhip with that type of retinal vein occluion; the particular dieae may or may not be one of the rik factor in a multifactorial cenario predipoing an eye to develop a particular type of retinal vein occluion. Baed on our tudy, we think that apart from a routine medical evaluation, an extenive and expenive workup for ytemic dieae i unwarranted in the vat majority of patient with retinal vein occluion.