Retinal vein thrombosis and risk of occult cancer: A nationwide cohort study

BACKGROUND: Retinal vein thrombosis has in case reports been reported a clinical sign of cancer, especially hematological cancer. However, it is unclear whether retinal vein thrombosis is a marker of underlying cancer, as is the case for deep venous thrombosis and pulmonary embolism. We investigated the risk of occult cancer in patients with retinal vein thrombosis.

METHODS: A nationwide population-based cohort study in Denmark on all patients diagnosed with a retinal vein thrombosis during 1994 and 2013. The main outcome measures were any cancer and site-specific cancers <6 months, 6-12 months, and 5 years following a retinal vein thrombosis diagnosis, as registered in the Danish Cancer Registry and the National Pathology Registry. We calculated the absolute cancer risk and computed standardized incidence ratios (SIRs) with 95% confidence intervals (CIs) for cancer within <6 months, 6-12 months, and 5 years following a retinal vein thrombosis diagnosis.

RESULTS: Among 9589 patients with retinal vein thrombosis, we observed 1514 cancer cases. The risk of any cancer was 1.2% <6 months and 28.8% after 5 years. The <6 months SIR was 1.20 (95% CI 0.99-1.44), 6-12 months SIR was 1.15 (95% CI 0.94-1.39), and the 5 years' SIR was 1.08 (95% CI 1.03-1.14). Stratification by age, gender, calendar year, and Charlson Comorbidity Index score did not change overall cancer risk estimates.

CONCLUSION: Retinal vein thrombosis was not an important clinical marker for occult cancer. An extensive diagnostic cancer workup does not appear warranted for retinal vein thrombosis patients.