Cardiovascular and thrombophilic risk factors in patients with retinal artery occlusion

Abstract

This article evaluates the prevalence of cardiovascular and thrombophilic risk factors in patients with retinal artery occlusion. Forty-one patients with a first episode of a retinal artery occlusion underwent complete ophthalmic examination, routine blood testing and specific laboratory tests for thrombophilia, such as fasting and postmethionine homocysteine, lipoprotein(a), plasminogen activator inhibitor-1, factor VIII, factor V Leiden, factor II G20210A polymorphism, lupus anticoagulant and anticardiolipin antibodies. The control population consisted of 100 healthy individuals comparable as regards age and sex. At univariate analysis, hypertension, smoking, dyslipidaemia (both high cholesterol and triglyceride levels), antiphospholipid antibodies, hyperhomocysteinaemia, elevated factor VIII and lipoprotein(a) levels were significantly associated with retinal artery occlusion; at multivariate analysis, adjusted for age, sex, traditional and thrombophilic risk factors, smoking, hypercholesterolaemia, elevated homocysteine and lipoprotein(a) levels confirmed their independent role as risk factors for retinal artery occlusion. In conclusion, the results of the present pilot study demonstrate that the prevalence of hypercholesterolaemia and smoking and the 'thrombophilic burden' are increased in patients with retinal artery occlusion. Our findings may have implications for the management of these patients, suggesting the need for an intensive and tailored secondary prevention and new therapeutic approaches.

Homocysteine in the Pathogenesis of Chronic Glaucoma

“…Mutation of MTHFR was also examined but no significant association could be found. Other notable studies 46,47 have reported similar findings and population based analysis from the Blue Mountains Eye Study also suggests HHcy and retinal artery emboli are weakly associated. 48 A small meta-analysis 49 suggests HHcy is more common in retinal artery occlusion but again no correlation with MTHFR mutation was found.…”

Retinal vein and artery occlusions: a risk factor for stroke in atrial fibrillation

“…Patients with retinal vascular occlusions often present to general practitioners or ophthalmologists, and have previously been associated with various cardiovascular risk factors [7][8][9][10][11][12][13], cerebral microembolisms [14], and cardiovascular events, including stroke and myocardial infarction [11,[15][16][17]. However, another study found that risk factor prevalence differed somewhat between patients with retinal and cerebral ischemia, indicating that there might be pathogenetic differences between retinal and cerebral ischemia [18].…”

Selective Thrombophilia Screening in Young Patients with Retinal Artery Occlusion

“…Arterial hypertension, diabetes mellitus, dyslipidemia, or vasculitis number among the risk factors that have been implicated in the development of RAO, but what role thrombophilic disorders might play remains unclear. Anecdotal reports do, however, suggest that an association with CRAO and BRAO [7,8,9,10,11,12] may well exist. Research to date has been unable to verify explicitly suggestions that thrombophilic disorders play a causative role.…”

“…Several cross-sectional studies have sought to estimate the prevalence in patients with RAO of systemic diseases that might predispose to in situ thrombosis [6,7]. Arterial hypertension, diabetes mellitus, dyslipidemia, or vasculitis number among the risk factors that have been implicated in the development of RAO, but what role thrombophilic disorders might play remains unclear.…”