Cancer-Type-Specific Risks of Retinal Vascular Occlusion: A Nationwide Population-Based Study.

OBJECTIVE

To evaluate the incidence and risk of retinal artery occlusion (RAO) and retinal vein occlusion (RVO) in cancer survivors across anatomical cancer subgroups.

DESIGN

Retrospective, nationwide, population-based cohort study.

PARTICIPANTS

A total of 462 185 individuals newly diagnosed with cancer in South Korea between 2011 and 2022.

METHODS

Incident cancer cases were identified from the Korean National Health Insurance Sharing Service database. Malignancies were classified into anatomical subgroups according to the International Classification of Diseases, 10th Revision. Patients with multiple primary cancers or prior RAO or RVO were excluded. Risks were evaluated using age- and sex-adjusted standardized incidence ratios (SIRs) compared with the general population and multivariable Cox and Fine-Gray models within the cancer cohort. Sensitivity analyses were performed.

MAIN OUTCOME MEASURES: Incident RAO and RVO after cancer diagnosis.

RESULTS

During a mean follow-up of 7.3 years, 873 RAO and 6657 RVO cases were identified. The 5-year cumulative incidence was 0.13% (95% confidence interval [CI], 0.12-0.14) for RAO and 0.91% (95% CI, 0.88-0.94) for RVO. Compared with the general population, cancer survivors had increased risks of RAO (SIR, 1.27; 95% CI, 1.19-1.36; P < 0.001) and RVO (SIR, 1.15; 95% CI, 1.12-1.17; P < 0.001). Hematologic malignancies showed the highest RAO risk (SIR, 2.50; 95% CI, 1.80-3.38; P < 0.001; hazard ratio [HR], 1.92; 95% CI, 1.41-2.62; P = 0.001) and an increased RVO risk (SIR, 1.52; 95% CI, 1.33-1.73; P < 0.001; Cox HR, 1.33; 95% CI, 1.17-1.52; P < 0.001). Eye and adnexa cancers showed the highest RVO risk (SIR, 3.03; 95% CI, 1.56-5.29; P = 0.002; Fine-Gray HR, 2.47; 95% CI, 1.41-4.34; P = 0.002). Findings were consistent in sensitivity analyses.

CONCLUSIONS

Cancer survivors have significantly increased risks of both RAO and RVO compared with the general population. Hematologic malignancies showed elevated risks for both outcomes, whereas eye and adnexa cancers were most strongly associated with RVO. Retinal vein occlusion may be a relevant complication warranting further study in cancer survivorship.

FINANCIAL DISCLOSURE(S): The authors have no proprietary or commercial interest in any materials discussed in this article.