Abstract: Objective To analyze the long-term follow-up in young patients aged 40 years or younger diagnosed with retinal vascular occlusion (RVO), and to investigate the risk of cardiovascular and cerebrovascular events. 
Methods Patients aged 40 years or younger and diagnosed with RVO at the Department of Ophthalmology, the Second Hospital of Hebei Medical University, from January 2008 to December 2016, were selected. Follow-up was conducted through medical record reviews, telephone calls, and outpatient visits. Data including the patient′s age, gender, affected eye, type of RVO, and medical history were recorded. 
Results A total of 156 patients were successfully followed up. Among them, 140 had RVO (89.74%), 10 had retinal artery occlusion (6.41%), and 6 had both RVO and retinal artery occlusion (3.85%). There were 103 males (66.03%). The age of onset ranged from 17 to 40 years, with an average of (33.36±5.66) years and a median of 34.5 years. The average follow-up time was (10.71±2.62) years. A total of 45 patients had systemic diseases, including hypertension (42 patients), diabetes (8 patients), and hyperlipidemia (2 patients) before onset. During the follow-up period, 28 new cases of hypertension, 11 new cases of diabetes, and 7 new cases of hyperlipidemia were identified. Eight patients (5.13%) experienced cardiovascular events, including myocardial infarction (2 patients, 1.28%), cerebral infarction (2 patients, 1.28%), and coronary heart disease (5 patients, 3.21%), with one patient experiencing multiple cardiovascular events and one death. 
Conclusion Young patients with RVO have a higher risk of cardiovascular and cerebrovascular events. When patients have hypertension, diabetes, hyperlipidemia and other high-risk factors that are prone to cardiovascular and cerebrovascular diseases, the probability of cardiovascular and cerebrovascular events can be reduced by controlling these high-risk factors. 

Key words: retinal vessels, cardiovascular diseases, cerebrovascular disorders