*Purpose: The risk of retinal vein occlusion(RVO) is known to increase in patients with chronic kidney disease, especially end-stage renal disease (ESRD). However, little is known about the incidence and correlates of RVO after kidney transplantation (KT). In this study, we aimed to compare the incidence of RVO of KT recipients compared with ESRD patients and healthy controls (HCs) in a long-term population-based cohort.

*Methods: We analyzed a Nationwide Health Insurance Database of South Korea and identified patients who received KT from the year of 2007 to 2015. After exclusion of previous history of RVO, KT recipients were selected and matched with ESRD patients and HCs with respect to age, sex and inclusion year. KT and ESRD patients were further matched with diabetes and hypertensions. The incidence (incidence ratio, IR per 1000) of RVO in KT recipients was compared with ESRD patients and HCs, respectively.

*Results: A total of 10,498 patients were analyzed in all three groups. Their mean age was 45.9 ± 10.6 years and 59.1% were men. When compared with HCs, the incidence of RVO was significantly higher in KT recipients (HCs vs KT: IR, 1.0 vs 2.7 per 1000 patient-year; adjusted HR [aHR], 1.5; 95% confidence interval [CI], 1.03-2.27), as well as in ESRD patients (HCs vs ESRD: IR, 1.0 vs 5.7; aHR, 3.21; 95% CI, 2.19-4.70). There was difference in the risk of RVO between ESRD patients and KT recipients (IR, 5.69 vs 2.74; aHR, 0.47; 95% CI, 0.39-0.58). In multivariate regression, old age, diabetes and high Charlson Comorbidity Index(CCI) scores were associated with increased risk of RVO although hypertension and preemptive KT didn’t show statistical significance in KT recipients.

*Conclusions: KT recipients showed a lower risk for RVO than ESRD patients, and the risk was greater than HCs. Increasing age, diabetes and high CCI scores were a risk factor for RVO in KT recipients.

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