Related Experiment Videos
Thrombophilic risk factors in patients with central retinal vein occlusion
R Marcucci1, L Bertini, B Giusti
1Dept Area Critica Medico-Chirurgica, Thrombosis Center, Az Ospedaliera Careggi, University of Florence, Italy.
Insights
Central retinal vein occlusion (CRVO) is linked to higher levels of homocysteine and plasminogen activator inhibitor-1 (PAI-1). These hemostatic factors, along with hypertension and hypercholesterolemia, are key risks for CRVO.
Area of Science:
- Ophthalmology
- Hematology
- Genetics
Background:
- Limited data exists on hemostatic risk factors in Central Retinal Vein Occlusion (CRVO).
- Understanding these factors is crucial for CRVO pathophysiology and management.
Purpose of the Study:
- To investigate metabolic and inherited risk factors for venous thrombosis in CRVO patients.
- To compare the prevalence of these risk factors between CRVO patients and healthy controls.
Main Methods:
- A case-control study involving 100 CRVO patients and 100 controls.
- Assessed levels of homocysteine, methylenetetrahydrofolate reductase (MTHFR) polymorphism, activated protein C resistance (APCR), factor V Leiden, PAI-1, and Lp(a).
- Multivariate analysis identified independent risk factors.
Main Results:
- CRVO patients exhibited significantly higher homocysteine levels, influenced by MTHFR C677T polymorphism.
- Prevalence of APCR, factor V Leiden, elevated PAI-1, and Lp(a) were higher in CRVO patients.
- Independent risk factors for CRVO included hyperhomocysteinemia, elevated PAI-1, hypertension, and hypercholesterolemia.
Conclusions:
- Hemostatic risk factors, particularly hyperhomocysteinemia and elevated PAI-1, play a significant role in CRVO development.
- Findings suggest a potential link between thrombophilia and the pathophysiology of CRVO.
- Further research into these hemostatic factors could inform CRVO prevention and treatment strategies.
Abstract:
Few and contrasting data are available on the prevalence of hemostatic risk factors in patients with central retinal vein occlusion (CRVO). Aim of this study was to investigate the metabolic and inherited risk factors for venous thrombosis in 100 CRVO patients (age: 59 yrs; range 18-77) and in 100 controls (age: 56 yrs; range 18-84). In patients homocysteine (Hcy) levels were significantly higher than in controls and were affected by the C677T methylenetetrahydrofolate reductase (MTHFR) polymorphism (p < 0.001). The prevalences of activated protein C resistance (APCR), factor V Leiden positivity, elevated PAI-1 and Lp(a) levels were significantly higher in patients with respect to controls. At multivariate analysis, only hyperhomocysteinemia (OR 11, 95% CI 3.6-36.2; p < 0.0001) and elevated PAI-1 levels (OR 8.9, 95% CI 3.5-41.3; p < 0.01), in addition to hypertension (OR 40.5, 95% CI 8.6-188.8; p < 0.00001) and hypercholesterolemia (OR 3.1, 95% CI 1.6-20.5; p < 0.05), were independent risk factors for CRVO. These data demonstrate a potential role of hemostatic risk factors in the pathophysiology of CRVO.