LAUSR

PURPOSE To evaluate the association between high-density lipoprotein (HDL) cholesterol levels and the future risk of retinal artery occlusion (RAO). DESIGN Population-based cohort study. METHODS This study used data provided by the Korean National Health Insurance Service. A total of 9,316,212 individuals over 40 years of age who participated in the Korean National Health Screening Program in 2013 or 2014 were included. Data on risk factors, including age, sex, income level, systemic comorbidities, behavioral factors, and baseline lipid profiles, were collected from health screening results and claims data. Patients were followed up until December 2018, and incident cases of RAO were identified using registered diagnostic codes from claims data. A prospective association between HDL cholesterol level and incident RAO was investigated using the multivariable-adjusted Cox proportional hazard model. RESULTS During an average follow-up period of 4.93 years, 9,878 patients were newly diagnosed with RAO. Compared to those with low HDL cholesterol levels (< 40 mg/dL), patients with high HDL cholesterol levels (≥ 60 mg/dL) had a lower risk of future RAO development with a hazard ratio (95% confidence intervals) of 0.78 (0.73-0.83) in the age and sex-adjusted model and 0.88 (0.83-0.95) in the full-adjusted model. The younger subgroup (< 60 years) had an HR of 0.81 in the high HDL cholesterol group compared to the low HDL cholesterol group, while the older subgroup (≥ 60 years) had an HR of 0.93 (p for interaction = 0.012). CONCLUSION Low HDL cholesterol level is an independent risk factor for the development of RAO.