Retinal vein occlusion and risk of cerebrovascular disease and myocardial infarction: A meta-analysis of cohort studies

Background and aims: Retinal vein occlusion (RVO) has been hypothesized to be associated with cerebrovascular disease and myocardial infarction (MI), but the results are inconclusive. We thus systematically evaluated the effect of RVO on the development of cerebrovascular disease and MI by a meta-analysis of cohort studies. Methods: PubMed, Embase and Web of Science databases were searched from inception to October 2015. Reference lists of retrieved papers were also reviewed. Cerebrovascular disease and MI were considered as the endpoints. Either fixed-or random-effects models were used to calculate the overall summary risk estimates. Subgroup and sensitivity analysis were performed to assess the potential sources of heterogeneity and the robustness of the pooled estimation. Results: Overall, a total of 9 cohort studies were included. Of these, 8 reported results on cerebrovascular disease and 5 reported on MI. The summary adjusted relative risks (RRs) for patients with RVO compared with the reference group were 1.50 (95% confidence interval [CI]: 1.32-1.69) for cerebrovascular disease and 1.28 (95% CI: 1.17-1.41) for MI. These associations were not significantly modified by geographic area, sample size, length of follow-up, and adjustment for potential confounding factors. Sensitivity analyses according to various inclusion criteria yielded similar results. No evidence of publication bias was observed. Conclusions: This meta-analysis provides further evidence supporting that RVO is associated with increased risk of future cerebrovascular disease and MI. (C) 2016 Elsevier Ireland Ltd. All rights reserved.