Influence of Smoking and Controlled Medical Conditions on the Risks of Branch Retinal Vein Occlusion in South Korea: A Population-Based Study

ABSTRACT

Purpose

To evaluate the effect of controlled medical conditions and risk of lifetime smoking history on the prevalence of branch retinal vein occlusion (BRVO) based on the Korea National Health and Nutrition Survey (KNHANES) database from 2017–2021.

Methods

The study population consisted of individuals aged ≥ 40 years who had completed ophthalmological questionnaires, underwent comprehensive ophthalmological examinations, and had at least one good-quality readable fundus photograph. Age, sex, hypertension status, diabetes status, dyslipidemia status, body mass index status, a history of chronic kidney disease (CKD), a lifetime smoking history of ≥ 100 cigarettes, and glaucoma were subjected to univariate and multivariate logistic regression analyses.

Results

The estimated prevalence (± standard error) of RVO was 0.5% (±0.1%). Significant risk factors were one-year increase in age, female sex, hypertension (stage 1, controlled, uncontrolled, and undiagnosed hypertension), underweight, pre-obesity, history of CKD, lifetime smoking history of ≥ 100 cigarettes, and glaucoma. Controlled diabetes decreased the risk of BRVO by 55% (odds ratio [OR] = 0.45, 95% confidence interval [CI] = 0.22–0.89, p = 0.022) and controlled hyper-high-density-lipoprotein (HDL)-cholesterolemia decreased the risk by 69% (OR = 0.31, 95% CI = 0.13–0.76, p = 0.010).

Conclusion

This study, for the first time, reported the association between lifetime smoking history of ≥ 100 cigarettes and BRVO in Korea. The risk of BRVO was lower in participants with controlled diabetes and hypo-HDL-cholesterolemia.

KEYWORDS:

• Diabetes
• hypertension
• hypo-HDL-cholesterolemia
• nationwide cross-sectional study
• retinal vein occlusion
• smoking

Acknowledgments

The authors like to thank Sun Gyu Choi at Biomedical Research Institute, Inje University Haeundae Paik Hospital, Busan, Korea for statistical help.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributors

Conceptualization: Kim E. Formal analysis: Lee JH. Funding acquisition: Kim E. Investigation: Lee JH. Methodology: Kim SH. Validation: all authors. Writing – original draft: Lee JH. Writing – review & editing: Kim SH, Kim E.

Data availability statement

Data of KNHANES are available on request at the website of the Korea Disease Control and Prevention Agency (http://knhanes.cdc.go.kr).

Additional information

Funding

This work was supported by 2023 Inje University Haeundae Paik Hospital research grant [grant No.2023-253].