ArticleGraefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie2026
Associations between psychiatric disorders and medication use, and retinal occlusion: a large-scale retrospective cohort study.
Article in Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo evaluate associations between psychiatric disorders, psychotropic medication use, and retinal vascular occlusion (RAO and RVO) risk using a large real-world database.
methodsThis retrospective cohort study used the TriNetX Research Network (~ 149 million patients). Psychiatric patients were identified via ICD-10 codes and grouped into three cohorts: (1) psychiatric disorders without pharmacologic treatment versus matched healthy controls, (2) medicated versus unmedicated psychiatric patients, and (3) single-class psychotropic medication users versus matched untreated patients. Extensive exclusions minimized confounding. Cohorts were propensity score-matched for demographic and clinical factors. The primary outcome was retinal occlusion within one year of treatment initiation.
resultsAmong 3,389,889 matched pairs, psychiatric disorders without medication were not associated with increased RO risk compared with controls (HR 0.97, 95% CI 0.87-1.07, p = 0.49). In contrast, among 2,990,601 matched pairs, psychotropic medication use was associated with a modest increase in RO risk (HR 1.20, 95% CI 1.09-1.33, p < 0.001). Class-specific analyses demonstrated a small but statistically significant association for selective serotonin reuptake inhibitors (SSRIs) (HR 1.17, 95% CI 1.03-1.32, p = 0.013), while no significant associations were observed for other medication classes. Patients who developed RO were older and had a higher burden of vascular comorbidities, including hypertension, diabetes, hyperlipidemia, and obstructive sleep apnea.
conclusionsPsychiatric disorders alone were not associated with increased RO risk, whereas psychotropic medications, particularly SSRIs, showed a modest increase. Despite low absolute incidence, medication exposure may contribute, warranting cardiovascular risk assessment and ophthalmologic monitoring.
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