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Optimization of the Retinal Vein Occlusion Mouse Model to Limit Variability
Published on: August 6, 2021
Elevated lipoprotein (a) levels are an independent risk factor for retinal vein occlusion
Claudia Kuhli-Hattenbach1, Wolfgang Miesbach2, Marc Lüchtenberg3
1Department of Ophthalmology, University Hospital, Goethe-University, Frankfurt am Main, Germany.
Insights
Elevated lipoprotein (a) [Lp(a)] is common in retinal vein occlusion (RVO) patients, especially younger ones. Screening for Lp(a) in those with a history of blood clots can help identify RVO risks.
Area of Science:
- Ophthalmology
- Cardiovascular Medicine
- Hematology
Background:
- Retinal vein occlusion (RVO) is a significant cause of vision loss.
- Thrombophilic disorders are implicated in the pathophysiology of RVO.
- Lipoprotein (a) [Lp(a)] is a recognized risk factor for cardiovascular and thrombotic events.
Purpose of the Study:
- To determine the prevalence of elevated lipoprotein (a) [Lp(a)] and other thrombophilic disorders in patients with retinal vein occlusion (RVO).
- To assess the association of Lp(a) and thrombophilia with age and cardiovascular risk factors in RVO patients.
Main Methods:
- Retrospective review of medical records for 100 RVO patients and 100 controls.
- Patients and controls were stratified into age subgroups: ≤45, >45-≤60, and >60 years.
- Thrombophilia screening was performed, and data were analyzed for associations with RVO, age, and risk factors.
Main Results:
- Elevated Lp(a) was significantly more prevalent in RVO patients (OR: 4.8, p < 0.0001).
- Age ≤60 years at the first thromboembolic event was a strong predictor of elevated Lp(a) (p = 0.0002).
- Independent risk factors for RVO included cardiovascular risk factors (OR: 3.1), elevated Lp(a) (OR: 5.2), and increased factor VIII activity (OR: 5.9).
Conclusions:
- Elevated plasma Lp(a) levels are significantly associated with the development of RVO.
- Selective screening for Lp(a) in younger RVO patients and those with a history of thromboembolism is recommended.
- Identifying elevated Lp(a) may aid in managing RVO risk.
Purpose:
To investigate the prevalence of lipoprotein (a) [Lp(a)] and other thrombophilic disorders among retinal vein occlusion (RVO) patients with regard to age and various risk factors.
Methods:
We retrospectively reviewed the medical records of 100 patients with central, hemicentral or branch RVO who had undergone routine thrombophilia screening. Data were compared with 100 controls. Both cohorts were divided into three subgroups (≤45 years, >45-≤60 years or >60 years), depending on the patients' age at the time of the RVO or a previous thromboembolic event.
Results:
Elevated Lp(a) plasma levels were significantly more prevalent among RVO patients than among controls (p < 0.0001; OR: 4.8). Moreover, we determined age ≤60 years by the time of the first thromboembolic event as a strong predictor of elevated Lp(a) (p = 0.0002). The coincidence of elevated Lp(a) with other coagulation disorders further increased the OR for RVO to 9.3 (95% CI 2.1-41.8). Multivariate analysis revealed the presence of cardiovascular risk factors (OR: 3.1, p = 0.0004), elevated lipoprotein (a) levels (OR: 5.2, p = 0.0001) and increased factor VIII activity (OR: 5.9, p = 0.001) as independent risk factors for the development of RVO among patients.
Conclusion:
Our results indicate that elevated plasma levels of Lp(a) are associated with the development of RVO. Selective screening of young patients and subjects with a personal or family history of thromboembolism may be helpful in identifying RVO patients with elevated Lp(a).
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