Moyamoya Disease Increased the Risk of Retinal Vascular Occlusion: A Nationwide Cohort Study in Korea.

IF 4.4 Q1 OPHTHALMOLOGY Ophthalmology. Retina Pub Date : 2024-10-22 DOI:10.1016/j.oret.2024.10.013

Min Seok Kim, Seonghee Nam, Si Un Lee, Sang Jun Park, Se Joon Woo, Jeongwoo Lee, Kwangsic Joo

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Abstract

Purpose: To investigate the risk of retinal vascular occlusion in patients with Moyamoya disease (MMD).

Design: Retrospective, longitudinal cohort study using the Korean National Health Insurance Service database.

Participants: Newly diagnosed MMD patients (n = 34 627), who were diagnosed between 2004 and 2022, and their propensity score matched controls (n = 136 945) were included.

Methods: We identified retinal vascular occlusion events using diagnostic codes for central retinal artery occlusion, other retinal artery occlusion, and retinal vein occlusion. After a washout period from 2002 to 2003, information on the diagnosis of retinal vascular occlusion was extracted in both MMD and control group during the follow-up period. The association between MMD and the risk of subsequent retinal vascular occlusion was investigated using a time-dependent Cox proportional hazard model and Kaplan-Meier survival analysis with log-rank test adjusted for age, sex, and comorbidities.

Main outcome measures: Hazard ratios (HRs) and 95% confidence intervals (CIs) for retinal vascular occlusion development according to the MMD.

Results: Moyamoya disease was associated with an increased risk of subsequent retinal vascular occlusion even after adjusting for confounding variables (HR, 1.22; 95% CI, 1.09-1.36). Among the subtypes of retinal vascular occlusion, central retinal artery occlusion showed a highest HR (2.23; 95% CI, 1.35-3.7). Incidence probability of retinal vascular occlusion was significantly higher among MMD patients than controls (P < 0.001, log-rank test).

Conclusions: In this nationwide population-based cohort study, patients with MMD in Korea had an elevated risk of retinal vascular occlusion, suggesting that the MMD is one of the risk factors for retinal vascular occlusion.

Financial disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

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莫亚莫亚病增加视网膜血管闭塞的风险：韩国全国队列研究。

目的：调查莫亚莫亚氏病（MMD）患者视网膜血管闭塞的风险：设计：利用韩国国民健康保险服务数据库进行回顾性纵向队列研究：研究对象：2004 年至 2022 年期间新确诊的 MMD 患者（34627 人）及其倾向得分匹配的对照组（136945 人）：我们使用视网膜中央动脉闭塞、其他视网膜动脉闭塞和视网膜静脉闭塞的诊断代码识别视网膜血管闭塞事件。经过2002年至2003年的清洗期后，在随访期间提取了MMD组和对照组的视网膜血管闭塞诊断信息。采用与时间相关的 Cox 比例危险模型和 Kaplan-Meier 生存分析，以及对年龄、性别和合并症进行调整后的对数秩检验，研究了 MMD 与后续视网膜血管闭塞风险之间的关系：主要结果指标：MMD导致视网膜血管闭塞的危险比（HRs）和95%置信区间（CIs）：结果：即使调整了混杂变量，MMD仍与视网膜血管闭塞的后续风险增加有关（HR，1.22；95% CI，1.09-1.36）。在视网膜血管闭塞的亚型中，视网膜中央动脉闭塞的 HR 值最高（2.23；95% CI，1.35-3.7）。MMD患者视网膜血管闭塞的发病概率明显高于对照组（P < 0.001，对数秩检验）：在这项全国性人群队列研究中，韩国的多发性硬化症患者发生视网膜血管闭塞的风险较高，这表明多发性硬化症是视网膜血管闭塞的风险因素之一。

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