Selective Thrombophilia Screening in Young Patients with Retinal Artery Occlusion

Abstract

Purpose: To investigate the prevalence of various thrombophilic disorders among young patients with retinal artery occlusion (RAO). Procedures: We retrospectively reviewed thrombophilia screening data of young patients ≤60 years of age with RAO and healthy controls matched for gender and age. Results: Thrombophilia screening data of 25 young patients and 62 healthy controls were analyzed. Mean patient age by the time of the RAO was 43.3 ± 10.8 years. Overall, thrombophilic defects were found to be present in 17 patients (68%) compared with 11 of 62 controls (17.7%; p < 0.0001). Multivariate logistic regression analysis confirmed a statistically significant association between the development of RAO and increased levels of lipoprotein(a) (odds ratio: 9.48; p = 0.001) and factor VIII (odds ratio: 6.41; p = 0.024). There was a strong association between the presence of thrombophilic disorders and a personal or family history of thromboembolism (p = 0.01). Conclusions: Our results indicate that screening for thrombophilic disorders among selected young patients with RAO yields positive results in a high percentage of cases.

Standard Diffusion-weighted MRI for the Diagnosis of Central Retinal Artery Occlusion

“…Frequent ophthalmoscopic findings include retinal edema, attenuation or segmentation of retinal arterioles and visible retinal artery emboli [2]. Similar to ischemic stroke, CRAO is mainly caused by emboli originating from large artery atherosclerosis [3][4][5] or car-K dioembolism [6,7], although a wider etiologic spectrum needs to be considered [8][9][10][11][12][13][14].…”

Multiple arterial and venous thromboses due to protein S deficiency - a case report

“…15 Studies showed that protein C deficiency, antithrombin III, factor V Leiden mutation, increased Factor V, lipoprotein A are responsible for retinal artery thrombosis. 16 Protein S deficiency is a very rare cause of retinal artery occlusion. The clinical manifestations of Protein S deficiency are venous thromboembolism, arterial thrombosis, and recurrent pregnancy loss.…”

Central Retinal Artery Occlusion Secondary to Patent Foramen Ovale: The Unexpected Journey of a Paradoxical Embolus

“…However, giant cell arteritis should be always considered in elderly patients since ocular symptoms in patients with ocular involvement include visual loss of varying severity and amaurosis fugax due to CRAO, cilioretinal artery occlusion or even arteritic ischemic optic neuropathy [10]. On the other side, in selected CRAO patients younger than 40 years, thrombophilia screening may yield positive results in a high percentage of cases [11]. Assuredly, in young patients with retinal arterial occlusion, cardiac valvular disease is assumed to be the most commonly identified etiologic factor in parallel to various associated conditions leading to a hypercoagulable state that render CRAO a complex event of multifactorial etiology via different mechanisms [12].…”