Incidence and risk factors associated with ischemic cerebrovascular disease in patients with retinal artery occlusion: a systematic review and meta-analysis.

This study investigates the incidence of ischemic cerebrovascular disease (CVD), including ischemic stroke, silent stroke, and transient ischemic attack (TIA) or amaurosis fugax (AF), in patients with retinal artery occlusion (RAO). Subgroup analyses focus on RAO type and study site, exploring the association between stroke occurrence and RAO types, alongside potential stroke risk factors. Two authors independently conducted a systematic review of PubMed, Embase, and SCOPUS databases adhering to PRISMA guidelines. Our PROSPERO registration number is CRD42022354977. The analysis of 101,952 patients in 46 studies, revealed a high incidence of ischemic CVD in RAO patients:13.6% (11.5-15.9) overall, 14.4% (11.4-18.0) central retinal artery occlusion (CRAO), and 22.2% (13.5-34.3) branch retinal artery occlusion (BRAO). Patients with CRAO had a higher risk of ischemic CVD, OR 1.59 (1.45-1.75) compared to BRAO. Patients with RAO had an OR of 2.75 (2.11-3.58) for ischemic CVD compared to non-RAO patients. Risk factors significantly associated with ischemic CVD in RAO patients included smoking (OR 1.16), atrial fibrillation (OR 1.32), dyslipidemia (OR 1.30), chronic heart failure (OR 1.51), and valvular heart disease (OR 1.60). These findings highlight the need for rigorous stroke screening, close monitoring, and aggressive management of modifiable risk factors in RAO patients to reduce their stroke risk.