Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026
Associations between psychiatric disorders and medication use, and retinal occlusion: a large-scale retrospective cohort study.
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Sadeghi Elham, Kozlov Michael, Hasan Nasiq, Lall Shreyaa Rohindra, Chhablani Jay
Аннотация
PURPOSE: To evaluate associations between psychiatric disorders, psychotropic medication use, and retinal vascular occlusion (RAO and RVO) risk using a large real-world database.
METHODS: This retrospective cohort study used the TriNetX Research Network (~ 149 million patients). Psychiatric patients were identified via ICD-10 codes and grouped into three cohorts: (1) psychiatric disorders without pharmacologic treatment versus matched healthy controls, (2) medicated versus unmedicated psychiatric patients, and (3) single-class psychotropic medication users versus matched untreated patients. Extensive exclusions minimized confounding. Cohorts were propensity score-matched for demographic and clinical factors. The primary outcome was retinal occlusion within one year of treatment initiation.
RESULTS: Among 3,389,889 matched pairs, psychiatric disorders without medication were not associated with increased RO risk compared with controls (HR 0.97, 95% CI 0.87-1.07, p = 0.49). In contrast, among 2,990,601 matched pairs, psychotropic medication use was associated with a modest increase in RO risk (HR 1.20, 95% CI 1.09-1.33, p < 0.001). Class-specific analyses demonstrated a small but statistically significant association for selective serotonin reuptake inhibitors (SSRIs) (HR 1.17, 95% CI 1.03-1.32, p = 0.013), while no significant associations were observed for other medication classes. Patients who developed RO were older and had a higher burden of vascular comorbidities, including hypertension, diabetes, hyperlipidemia, and obstructive sleep apnea.
CONCLUSIONS: Psychiatric disorders alone were not associated with increased RO risk, whereas psychotropic medications, particularly SSRIs, showed a modest increase. Despite low absolute incidence, medication exposure may contribute, warranting cardiovascular risk assessment and ophthalmologic monitoring.
METHODS: This retrospective cohort study used the TriNetX Research Network (~ 149 million patients). Psychiatric patients were identified via ICD-10 codes and grouped into three cohorts: (1) psychiatric disorders without pharmacologic treatment versus matched healthy controls, (2) medicated versus unmedicated psychiatric patients, and (3) single-class psychotropic medication users versus matched untreated patients. Extensive exclusions minimized confounding. Cohorts were propensity score-matched for demographic and clinical factors. The primary outcome was retinal occlusion within one year of treatment initiation.
RESULTS: Among 3,389,889 matched pairs, psychiatric disorders without medication were not associated with increased RO risk compared with controls (HR 0.97, 95% CI 0.87-1.07, p = 0.49). In contrast, among 2,990,601 matched pairs, psychotropic medication use was associated with a modest increase in RO risk (HR 1.20, 95% CI 1.09-1.33, p < 0.001). Class-specific analyses demonstrated a small but statistically significant association for selective serotonin reuptake inhibitors (SSRIs) (HR 1.17, 95% CI 1.03-1.32, p = 0.013), while no significant associations were observed for other medication classes. Patients who developed RO were older and had a higher burden of vascular comorbidities, including hypertension, diabetes, hyperlipidemia, and obstructive sleep apnea.
CONCLUSIONS: Psychiatric disorders alone were not associated with increased RO risk, whereas psychotropic medications, particularly SSRIs, showed a modest increase. Despite low absolute incidence, medication exposure may contribute, warranting cardiovascular risk assessment and ophthalmologic monitoring.