RETINAL VEIN OCCLUSION IN PATIENTS 55 YEARS AND YOUNGER WITH MIGRAINE: A Comparative Outcomes Analysis.

Abstract

To evaluate the risk of retinal vein occlusion (RVO) in patients 55 years and younger with a history of migraine compared with a control group without migraine. Using the TriNetX platform, a retrospective cohort analysis was conducted comparing patients 55 years and younger with a diagnosis of patients with migraine to nonmigraine undergoing routine health examinations. The study period comprised 20 years from March 2006 through March 2026. 1:1 nearest-neighbor propensity score matching without replacement was used to balance baseline demographics, body mass index, and comorbidities between cohorts. RVO incidence was the primary outcome measure, including central retinal vein occlusion and branch retinal vein occlusion subtypes, defined by International Classification of Disease-10 codes. After propensity score matching, the combined matched sample comprised 3,482,652 individuals (1,741,326 per cohort). RVO (composite): 462 events in the migraine cohort versus 325 events in the control cohort (risk ratio [RR] = 1.422, 95% confidence interval [CI]: 1.234-1.638; P < 0.001; hazard ratio [HR] = 1.331, 95% CI: 1.155-1.534; log-rank χ 2 = 15.655; P < 0.001). Central retinal vein occlusion: 303 versus 206 events (RR = 1.471, 95% CI: 1.232-1.756; P < 0.001; HR = 1.375, 95% CI: 1.152-1.641; log-rank χ 2 = 12.511; P < 0.001). Branch retinal vein occlusion: 221 versus 154 events (RR = 1.435, 95% CI: 1.168-1.763; P = 0.001; HR = 1.340, 95% CI: 1.090-1.646; log-rank χ 2 = 7.798; P = 0.005). Patients 55 years and younger with a history of migraine have an increased risk of developing RVO compared with controls without migraines.