Prevalence and associated factors of retinal vein occlusion in the Korean National Health and Nutritional Examination Survey, 2008-2012 A cross-sectional observational study

Abstract

Retinal vein occlusion (RVO) is the second most common retinal vascular diseases and there are only a few Asian population-based studies with small samples. Hypertension is one of a modifiable risk factor of RVO, but no recent studies have shown the relationship between RVO and hypertension control status. We aimed to investigate the prevalence of RVO and its associated factors in an adult Korean population. A nationwide population-based, cross-sectional study. We enrolled 37,982 participants from the Korea National Health and Nutrition Examination Survey who were 19 years or older and who had undergone ophthalmologic exams from 2008 through 2012. All participants underwent a comprehensive ophthalmic examination, standardized ophthalmic and health interviews, and laboratory investigations. Digital fundus photographs were interpreted by retinal specialists who investigated for the presence of RVO. The prevalence of RVO was then estimated. RVO-associated factors were determined using step-wise logistic regression analyses. We also performed a subgroup analysis to evaluate the association between hypertension and RVO according to hypertension control status and antihypertensive medication use. Of those enrolled participants, 25,765 participants met our study criteria and were included in the analyses. The overall RVO prevalence (n=205) was 0.6±0.1% (0.6±0.1% for branch RVO and<0.1% for central RVO), and no sex differences were observed. In multivariate logistic regression analyses after adjusting for all potential risk factors, we found the following factors to be significantly associated with RVO: old age (odds ratio (OR)=1.72, 95% CI: 1.27-2.34), hypertension (OR=2.56, 95% CI: 1.31-5.08), history of stroke (OR=2.08, 95% CI: 1.01-4.45), and hypercholesterolemia (OR=1.84, 95% CI: 1.01-3.35). In a subset of participants with hypertension, participants with uncontrolled hypertension (OR=3.46, 95% CI: 1.72-6.94) and unmedicated hypertension (OR= 4.12, 95% CI: 2.01-8.46) were more significantly associated with RVO than participants without hypertension. RVO prevalence in Korea was moderate relative to that in the rest of the world, and RVO-associated factors were similar to those identified in other population-based studies. Well-controlled hypertension and antihypertensive medication showed inverse association with RVO.