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Activated protein C resistance--low incidence in glaucomatous optic disc haemorrhage and central retinal vein

S L Graham1, I Goldberg, B Murray

  • 1Department of Ophthalmology, Prince of Wales Hospital, Sydney, NSW.

Australian and New Zealand Journal of Ophthalmology
|August 1, 1996
PubMed
Abstract

Insights

Activated protein C (APC) resistance, a risk factor for venous thrombosis, was investigated in glaucoma patients with nerve fibre layer hemorrhages and central retinal vein occlusion (CRVO). No significant association was found between these conditions and APC resistance.

Area of Science:

  • Ophthalmology
  • Hematology
  • Genetics

Background:

  • Activated protein C (APC) resistance is a known risk factor for venous thrombosis.
  • This resistance is often linked to the factor V Leiden gene mutation, prevalent in 2-4% of the general population.
  • Ocular vascular conditions like glaucoma with nerve fibre layer (NFL) hemorrhages and central retinal vein occlusion (CRVO) warrant investigation for potential thrombotic links.

Purpose of the Study:

  • To determine if a significant association exists between glaucomatous NFL hemorrhages or CRVO and activated protein C (APC) resistance.
  • To investigate the prevalence of APC resistance in patients with specific ocular vascular conditions.

Main Methods:

  • A case-control study involving 23 patients with glaucomatous NFL hemorrhages and 23 with CRVO (including 11 young-onset cases).
  • Control groups included 80 blood donors and 33 staff members.
  • Activated protein C (APC) resistance was assessed by measuring clotting times and calculating APC ratios; factor V Leiden gene testing was performed for positive cases.

Main Results:

  • No APC resistance was detected in glaucoma patients.
  • Only one young-onset CRVO patient tested positive for APC resistance.
  • The prevalence of APC resistance in the patient groups was not significantly different from the control groups (4 out of 113 controls tested positive).

Conclusions:

  • This study did not find a clear association between glaucomatous NFL hemorrhages or CRVO and activated protein C (APC) resistance.
  • The negative finding is significant given the established link between APC resistance and venous thrombosis.
  • Further research may be needed to fully elucidate the relationship between thrombophilia and ocular vascular diseases.

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