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Activated protein C resistance is a risk factor for central retinal vein occlusion
R Marcucci1, L Bertini, A A Liotta
1Dipartimento Area Critica Medico-Chirurgica, Università degli Studi di Firenze.
Insights
Activated protein C resistance is a significant inherited risk factor for central retinal vein occlusion (CRVO). This finding suggests a potential role for activated protein C resistance in the development of CRVO.
Area of Science:
- Ophthalmology
- Hematology
- Genetics
Background:
- Central retinal vein occlusion (CRVO) is a common retinal vascular disorder.
- Data on inherited hemostatic risk factors for CRVO are limited and conflicting.
Purpose of the Study:
- To investigate inherited hemostasis-related risk factors for venous thrombosis in CRVO patients.
- To compare the prevalence of these risk factors between CRVO patients and control subjects.
Main Methods:
- A case-control study involving 53 CRVO patients and 53 controls.
- Analysis of plasma levels of antithrombin III, protein C, and protein S.
- Univariate and multivariate analyses to assess associations with CRVO, adjusting for traditional vascular risk factors.
Main Results:
- No significant differences in antithrombin III, protein C, or protein S levels were observed between groups.
- Activated protein C resistance (OR 5.8) and Factor V Leiden (OR 4.4) were associated with CRVO in univariate analysis.
- Activated protein C resistance remained the sole independent risk factor (OR 11.5) after adjusting for covariates.
Conclusions:
- Activated protein C resistance is a significant independent risk factor for central retinal vein occlusion.
- These findings suggest a role for activated protein C resistance in the pathophysiology of CRVO.
- Further research into thrombophilia screening for CRVO patients may be warranted.
Abstract:
Central retinal vein occlusion is one of the most common retinal vascular disorders. Few and contrasting data are available on the prevalence of hemostatic risk factors in patients with central retinal vein occlusion. The aim of this study was to investigate the most common hemostasis-related inherited risk factors for venous thrombosis in a group of 53 central retinal vein occlusion patients (median age 59 years, range 18-77 years) and in 53 comparable control subjects (median age 57 years, range 22-84 years). No difference was found in antithrombin III, protein C and protein S plasma levels between patients and controls. At univariate analysis, activated protein C resistance (odds ratio 5.8) and factor V Leiden (odds ratio 4.4) were significantly associated with central retinal vein occlusion whereas G20210A polymorphism of the prothrombin gene was not. After adjustment for sex, age, and the other classic vascular risk factors (hypertension, diabetes, hypercholesterolemia, smoking) activated protein C resistance remained the only independent risk factor for central retinal vein occlusion (odds ratio 11.5). These data indicate that activated protein C resistance may play a role in the pathophysiology of central retinal vein occlusion.