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Central retinal vein occlusion and thrombophilia
1Department of Haematology, Birmingham Heartlands Hospital, UK. feganc@heartsol.wmids.nhs.uk
Insights
Central retinal vein occlusion (CRVO) is linked to thrombophilic conditions. Hyperhomocysteinaemia and antiphospholipid syndrome are identified causes, while hereditary factors appear less significant.
Area of Science:
- Ophthalmology
- Vascular Medicine
- Hematology
Background:
- Central retinal vein occlusion (CRVO) is a common vascular eye disease.
- Its development is multifactorial, influenced by local eye factors and systemic conditions.
- Thrombophilic conditions are increasingly recognized as potential contributors.
Purpose of the Study:
- To critically review existing studies on the role of thrombophilic conditions in CRVO.
- To clarify conflicting results regarding the etiological significance of these conditions.
- To identify specific thrombophilic factors associated with CRVO.
Main Methods:
- Systematic review and critical appraisal of published research.
- Analysis of studies investigating the association between thrombophilia and CRVO.
- Evaluation of evidence for various thrombophilic states, including hereditary and acquired conditions.
Main Results:
- Hyperhomocysteinaemia and antiphospholipid syndrome are identified as causes of CRVO.
- Evidence suggests that disorders impairing fibrinolysis may also contribute to CRVO.
- Common hereditary thrombophilic conditions do not appear to be major risk factors for CRVO.
Conclusions:
- Specific thrombophilic conditions like hyperhomocysteinaemia and antiphospholipid syndrome are implicated in CRVO.
- Hypofibrinolysis disorders may play a role in the pathogenesis of CRVO.
- Further large-scale studies are required to definitively establish the role of hereditary thrombophilias in CRVO.
Abstract:
Central retinal vein occlusion is one of the commonest vascular diseases of the eye. The pathogenesis is multifactorial with both local factors and systemic diseases being aetiologically important. Many thrombophilic conditions have recently been identified and studies looking at their potential role in CRVO have been undertaken. The aim of this review is to critically appraise these studies as to date many have given conflicting results, making it far from clear what role thrombophilic conditions play in CRVO. It appears that hyperhomocysteinaemia and antiphospholipid syndrome are causes of CRVO and there is evidence that disorders causing hypofibrinolysis may also be important. The common hereditary thrombophilic conditions however do not appear to be strong risk factors but larger studies are needed for a definitive answer.