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The following is a summary of “Is there an association between retinal vein occlusion and cerebrovascular accident? A systematic review and meta-analysis,” published in the March 2025 issue of BMC Ophthalmology by Chen et al. 

Retinal vein occlusion (RVO) may elevate the risk of cerebrovascular accidents (CVA) due to shared vascular pathology between the retina and brain.  

Researchers conducted a retrospective study to estimate the risk of CVA, including ischemic and hemorrhagic subtypes, in individuals with RVO.  

They performed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines study and registered it in PROSPERO (CRD42024557820). A systematic search of PubMed, Cochrane Library, Scopus, Web of Science, and Embase was carried out from inception to February 2025. Studies analyzing CVA incidence after RVO in adults aged 18 years and older were included and 2 independent reviewers selected studies, extracted data, and assessed quality using the Cochrane Risk of Bias tool for Non-Randomized Studies (ROBINS-I). Meta-analysis was performed with Comprehensive Meta-Analysis (CMA) software version 3.7, applying a fixed-effects model for low heterogeneity. Subgroup and sensitivity analyses were performed based on RVO type [branch RVO (BRVO) vs central RVO (CRVO)] and stroke subtype (ischemic vs hemorrhagic CVA). Egger’s test and funnel plots were employed to estimate publication bias.  

The results showed that 14 studies (n = 97,812 individuals) were included. The pooled event rate for CVA after RVO was 37.5% (95% CI: 37.3%–37.8%), with no significant heterogeneity (I<sup style=”vertical-align: sup;”>2</sup> = 0%, P = 0.97). Subgroup analysis indicated similar rates for ischemic CVA (37.8%; 95% CI: 37.3%–38.3%) and hemorrhagic CVA (32.7%; 95% CI: 32.3%–33.1%) across BRVO and CRVO. The mortality rate following CVA in individuals with RVO was 69.0% (95% CI: 68.4%–69.5%), underscoring the severity of stroke outcomes. The incidence of ischemic cardiovascular events, including myocardial infarction, was 15.7% (95% CI: 15.4%–16.0%), emphasizing the need for cardiovascular monitoring. The occurrence of deep vein thrombosis (DVT) was low at 0.05%, but it remained clinically relevant for high-risk populations. Publication bias was minimal, confirmed by Egger’s test (P > 0.24) and symmetrical funnel plots and sensitivity analyses validated the reliability of the pooled calculations.  

Investigators concluded that RVO elevated the risk of stroke and death, necessitating aggressive cardiovascular risk management and multidisciplinary care. 

Source: bmcophthalmol.biomedcentral.com/articles/10.1186/s12886-025-03944-w