Coagulation abnormalities and their neuro-ophthalmologic manifestations

Congenital and acquired hypercoagulable states arise from an imbalance between procoagulant and anticoagulant forces. Although these conditions are present throughout the vascular tree, they typically give rise to local thrombotic lesions in discrete segments of the veins or arteries; this suggests that focal defects in the vascular wall or blood flow must be associated with a hypercoagulable state to produce thrombosis. Numerous new factors associated with hypercoagulability have been described in the past few years. Congenital and acquired hypercoagulable states are reviewed here, with an emphasis on recent data on focal thrombosis involving the eye and central nervous system.