Risk Of Retinal Artery Occlusion In Patients With Primary Open-Angle Glaucoma: A Retrospective Cohort Study
Published 2026 - 44th Congress of the ESCRS
Reference: POGAU025 | Type: Free paper | DOI: 10.82333/nfqa-xf45
Authors: Dr Nadav Shemesh* 1 , Dr Itay Nitzan 1 , Dr Shoham Kubovsky 1 , Dr Tehila Shalmov 1 , Dr Nir Erdinest 1 , Prof. Jaime Levy 1 , Dr Itay Lavy 1
1Ophthalmology,Hadassah Medical Center,Jerusalem,Israel
Purpose
To evaluate the risk of retinal artery occlusion (RAO) in individuals with primary open-angle glaucoma (POAG) using a large-scale real-world database, and to determine whether POAG constitutes an independent risk factor for retinal ischemic events.
Setting
This retrospective cohort study used the TriNetX Global Collaborative Network to analyze electronic health records from 145 healthcare organizations.
Methods
Adults aged 18 years or older with POAG were compared with non-POAG controls. Propensity score matching (PSM) was performed 1:1 on 11 baseline characteristics. Incident RAO one day after and within 5 years after POAG diagnosis. Hazard ratios (HRs) were calculated using Cox proportional hazard models. Kaplan-Meier analysis was conducted to compare RAO-free survival using log-rank tests.
Results
After PSM, there were 255,216 patients in each cohort (50.9% female; mean age 68.2 years). POAG patients had a significantly increased risk of RAO compared with controls (3.46 vs 1.94 per 10,000; HR 2.16; 95% CI, 1.93–2.42; p < 0.001). The association persisted in sex-stratified and extended follow-up analyses. Anti-glaucoma medications did not significantly alter risk.
Conclusions
This large-scale cohort study identifies POAG as an independent risk factor for RAO. These findings highlight the importance of vascular risk assessment in POAG management and highlight the need for increased vigilance for retinal ischemic events in this population.