Retinal vein occlusion as the surrogate marker for premature brain aging in young patients

Purpose. We investigated cerebral small vessel disease (SVD) in patients with incidental retinal vein occlusion (RVO). METHODS. This retrospective, case-control, observational trial included 125 patients with RVO who underwent brain magnetic resonance imaging (MRI) and 1105 age-matched controls who underwent comprehensive medical interviews and MRI. Underlying cardiovascular diseases and MRI findings were investigated in the patients with RVO according to age (<60 or ≥60 years) and RVO occlusion level (central or branch). The characteristics of underlying cardiovascular disease and MRI findings were compared between the younger patients with RVO and age-matched controls. The cerebrovascular burden also was assessed in the younger patients with RVO. Results. The mean age of the patients with RVO was 63.9 6 12.1 years and the predominant underlying disease was hypertension (72/125, 58%). The older RVO group had a longer history of hypertension and less smoking history. The prevalence of cerebral SVD in the RVO group was 54% (68/125), and was significantly higher in older than in younger patients with RVO (62% [53/86] vs. 38% [15/39], P = 0.016). However, the latter had a significantly higher prevalence of cerebral SVD than their age-matched controls (38% [15/39] vs. 4% [47/1105], P < 0.001). There was no difference in prevalence of cerebral SVD between the central and branch RVO groups (P = 0.478). Conclusions. Cerebral SVD presented frequently in patients with RVO and was magnified in young patients, suggesting that RVO is a surrogate marker for cerebral SVD.