Thrombophiliefaktoren als Auslöser retinaler Gefäßverschlüsse

Lerche, R.-C.; Wilhelm, Claudia; Eifrig, B.; Richard, Gisbert

doi:10.1007/s003470170113

Cited by 9 publications

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“…Thrombophilia has been reported to play an important pathoetiologic role in RAO and RVO, 18 as previously documented in this article, which is congruent with findings in our’s 18 , 21 , 53 and other’s 70 – 74 studies. Thrombophilia is a known pathoetiology for adverse obstetrical outcomes, including, as in the current study, miscarriage, 75 – 80 recurrent miscarriage, 48 , 49 , 57 , 81 pre-eclampsia, 82 , 83 and eclampsia.…”

Section: Discussionsupporting

confidence: 92%

Retinal vascular occlusion: a window to diagnosis of familial and acquired thrombophilia and hypofibrinolysis, with important ramifications for pregnancy outcomes

Dixon¹,

Bruce²,

Glueck³

et al. 2016

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AimOur specific aim was to document the pathoetiologic importance of thrombophilia among females presenting with severe ischemic retinal vein (RVO) or retinal artery (RAO) occlusion, without typical risk factors, and to emphasize that the ophthalmologists’ diagnosis of thrombophilia has important diagnostic and therapeutic downstream ramifications for nonocular thrombosis, including reproductive outcomes.MethodsWe evaluated familial and acquired thrombophilia in 60 females with RVO (central RVO, n=52; branch RVO, n=8) and 16 with RAO (central RAO, n=11; branch RAO, n=5). They were referred by retinologists, without typical risk factors for RVO/RAO and/or severe ocular ischemic presentation. We focused on extraocular thrombotic events, particularly pregnancy complications, including unexplained spontaneous abortion, pre-eclampsia–eclampsia. Thrombophilia measurements in the 76 females were compared with 62 healthy normal females without ocular vascular occlusions (OVOs).ResultsThe 76 females with OVO were more likely than 62 normal female controls to have high homocysteine (24% vs 0%, P<0.0001), high anticardiolipin antibody (immunoglobulin M, 17% vs 3%, P=0.012), high (>150%) factor VIII (42% vs 11%, P<0.0001), and high (>150%) factor XI (22% vs 4%, P=0.004). Of the 76 females, 26 (34%) had ≥1 spontaneous abortion; 17 (22%) had ≥2 spontaneous abortions and/or pre-eclampsia–eclampsia. Compared to 62 healthy female controls, these 17 females with pregnancy complications had high homocysteine (29% vs 0%, P=0.0003), high anticardiolipin antibody immunoglobulin M (24% vs 3%, P=0.02), high factor VIII (38% vs 11%, P=0.02), and were marginally more likely to be heterozygous for the factor V Leiden mutation (19% vs 3%, P=0.058).ConclusionIn females lacking typical risk factors for retinal vascular occlusion or severely ischemic presentation, by diagnosing thrombophilia as an etiology for OVO, the ophthalmologist opens a window to family screening and preventive therapy, with particular relevance to pregnancy outcomes and venous thromboembolism.

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Section: Discussionsupporting

confidence: 92%

Retinal vascular occlusion: a window to diagnosis of familial and acquired thrombophilia and hypofibrinolysis, with important ramifications for pregnancy outcomes

Dixon¹,

Bruce²,

Glueck³

et al. 2016

OPTH

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show abstract

“…Hyperhomozysteinämie und das Antiphospholipid-Antikörper-Syndrom als Risikofaktoren (Janssen et al 2005;Fegan 2002;Ingerslev 1999). Bei jungen Patienten ohne Risikofaktoren ist es jedoch nach einem Verschlussereignis im Auge sinnvoll, nach Veränderungen der Blutgerinnung, einer erhöhten APC-Resistenz, einem Faktor-V-Leiden oder einem Faktor-XII-Mangel zu suchen, da diese Patienten meist kein kardiovaskuläres Risikoprofil aufweisen (Lerche et al 2001;Kuhli-Hattenbach et al 2009). Bei Patienten mit einem Hyperviskositätssyndrom, verursacht durch hämatologische Grunderkrankungen, die die Blutviskosität durch Vermehrung der Blutbestandteile erhöhen, sind immer beide Augen betroffen (Rodriguez und Eliott 2001;Dithmar et al 2003).…”

Section: Von Den Hereditären Thrombophilien Gelten Nachweislich Nur Dieunclassified

Prospektive Evaluation kardiovaskulärer Risikofaktoren bei Patienten mit venösen Gefäßverschlüssen im Auge

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Anti-Phospholipid-Syndrom mit serologischen Markern (Gefäßverschluss als Notfall)

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Thrombophiliefaktoren als Auslöser retinaler Gefäßverschlüsse

Cited by 9 publications

References 12 publications

Retinal vascular occlusion: a window to diagnosis of familial and acquired thrombophilia and hypofibrinolysis, with important ramifications for pregnancy outcomes

Retinal vascular occlusion: a window to diagnosis of familial and acquired thrombophilia and hypofibrinolysis, with important ramifications for pregnancy outcomes

Prospektive Evaluation kardiovaskulärer Risikofaktoren bei Patienten mit venösen Gefäßverschlüssen im Auge

Anti-Phospholipid-Syndrom mit serologischen Markern (Gefäßverschluss als Notfall)

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