Abstract: Objective To investigate the association between the Chinese Visceral Adiposity Index (CVAI) and retinal vein occlusion (RVO). Design Cross-sectional study. Participants A total of 8,499 participants (16,998 eyes) from the Kailuan Eye Study with determinable RVO status and non-missing CVAI data were included. Among them, 111 participants (114 eyes) had RVO, and 8,388 participants (16,776 eyes) had no RVO. Only data from the right eye were analyzed. Methods Baseline characteristics were compared between participants with and without RVO. Multivariable logistic regression was used to assess the association between CVAI and RVO. Additional subgroup analyses were performed by age and sex. Restricted cubic spline (RCS) Logistic regression was further applied to examine the dose-response relationship between CVAI and the risk of RVO. Main Outcome Measures CVAI and RVO. Results Compared with participants without RVO, those with RVO were older, more likely to be male, and had higher prevalences of diabetes and hypertension. They also had higher systolic blood pressure, diastolic blood pressure, body mass index, waist circumference, fasting blood glucose, creatinine, urea, waist-to-hip ratio, and CVAI levels (all P<0.05). In multivariable logistic regression analysis, CVAI remained significantly associated with RVO after adjustment for diabetes, history of hypertension, and creatinine level [odds ratio (OR)= 1.371, 95% CI, 1.143-1.643, Wald χ2=11.619, P=0.001]. Subgroup analyses showed that the association between CVAI and RVO appeared more pronounced in men and in participants aged ≥60 years; however, neither the age interaction nor the sex interaction was statistically significant (Wald χ2=1.079, P for interaction=0.299 and Wald χ2=1.196, P for interaction=0.658, respectively). RCS Logistic regression analysis demonstrated a significant overall association between CVAI and the risk of RVO (likelihood ratio χ2=12.099, P for overall association=0.007), whereas no significant nonlinearity was detected (likelihood ratio χ2=1.447, P for nonlinearity=0.485). Conclusion Higher CVAI was independently associated with RVO. No significant nonlinear relationship was observed between CVAI and RVO risk, and the dose-response pattern was more consistent with an approximately linear positive association. These findings suggest that CVAI may help identify visceral adiposity dysfunction and metabolic-vascular risk burden in patients with RVO or individuals at high risk, and may provide supplementary information for systemic risk factor screening and comprehensive management.

Key words: Retinal vein occlusion, Chinese visceral adiposity index, Visceral obesity, Risk factor, Kailuan Eye Study