Retinal Vessel Occlusion Linked To Increased Mortality in Hemodialysis Patients

MedicalResearch.com Interview with:
Te-Chao Fang, MD, PhD.
Division of Nephrology, Department of Internal Medicine,
Wan Fang Hospital, Taipei Medical University,
Taipei, Taiwan

Medical Research: What is the background for this study? What are the main findings?

Dr. Fang: Patients undergoing hemodialysis (HD) often develop retinal ischemia due to underlying diseases (mostly such as diabetes and malignant hypertension), uremic status, and vessel calcification, etc. Retinal ischemia, derived from retinal vascular occlusion, can lead to serious deterioration of vision and a reduced quality of life, so it is important to understand the long-term outcomes of retinal vascular occlusion in hemodialysis patients. We used the Taiwan National Health Insurance research database from 1997 to 2008 to examine subsequent outcomes of retinal artery occlusion (RAO) or retinal vein occlusion (RVO) in incident HD patients on the mortality, hemorrhagic stroke, ischemic stroke, coronary artery disease (CAD), acute coronary syndrome (ACS), and peripheral arterial occlusive disease (PAOD). In this paper, we have shown that HD patients with RAO had increased risks of mortality, ischemic stroke, CAD, ACS, and PAOD. Further, HD patients with RVO had significantly increased risks of mortality, hemorrhagic stroke, CAD, and ACS. This nationwide cohort study reports that risks of mortality and atherosclerotic complications were increased in incident hemodialysis patients subsequently with retinal vascular occlusion.

Medical Research: What should clinicians and patients take away from your report?

Dr. Fang: We know that risks of mortality and atherosclerotic events are increasing in incident  hemodialysis patients subsequently with retinal vascular occlusion. Thus, clinicians should arrange screening examinations of atherosclerotic disorders for hemodialysis patients subsequently with retinal vascular occlusion. HD patients should understand that retinal ischemia, derived from retinal vascular occlusion is a high risk of mortality and atherosclerotic events and need to further examine the atherosclerotic disorders.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Fang:    In this paper, we showed that risks of retinal vascular occlusion is related to risks of cerebrovascular diseases and cardiovascular diseases, and further raise a higher mortality in hemodialysis patients. This study merits further investigations in other prospective cohorts or groups to examine whether the similar results are shown. In addition, it is important to evaluate whether the early screening and intervention for atherosclerotic disorders could reduce the mortality and atherosclerotic events in HD patients subsequently with retinal vascular occlusion.

Citation:

Hsieh T, Chou C, Chen J, et al. Risk of Mortality and of Atherosclerotic Events Among Patients Who Underwent Hemodialysis and Subsequently Developed Retinal Vascular Occlusion: A Taiwanese Retrospective Cohort Study. JAMA Ophthalmol. Published online December 17, 2015. doi:10.1001/jamaophthalmol.2015.5052

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Te-Chao Fang, MD, PhD. (2015). Retinal Vessel Occlusion Linked To Increased Mortality in Hemodialysis Patients 

Last Updated on December 21, 2015 by Marie Benz MD FAAD