Hypercoagulability and high lipoprotein(a) levels in patients with central retinal vein occlusion.
A series of coagulation parameters and lipoprotein(a) (Lp(a)) were explored in plasma from 40 patients with central retinal vein occlusion (CRVO, non-ischemic type n = 12; ischemic type n = 28) free of local and systemic predisposing factors, 1 to 12 months after the acute event. Forty age- and sex-matched patients with cataract served as controls. Prothrombin fragment 1.2 (F1.2), D-dimer, FVII:C--but not FVII:Ag--were higher and fibrinogen was lower in CRVO patients than in controls. Patients with non-ischemic CRVO had higher F1.2 and FVII:C and lower heparin cofactor II than patients with ischemic CRVO. Lp(a) levels greater than 300 mg/l were observed in 12 patients with CRVO and in 4 controls (30% vs 10%, p < 0.025). Patients with high Lp(a)--consistently associated with the S2 phenotype--had higher FVII:C, FVII:C/Ag ratio, and fibrinogen than the remaining CRVO patients. Plasma F1.2 and D-dimer correlated fairly in controls (r = 0.41) and patients with normal Lp(a) levels (r = 0.55), but they did not in the group of patients with high Lp(a) (r = 0.19), where the latter parameter was negatively related to D-dimer (r = -0.55). There was no dependence of the abnormalities observed on the time elapsed from vein occlusion. The findings of activated FVII and high F1.2, D-dimer, and Lp(a) are not uncommon in patients with CRVO. Increased thrombin formation with fibrin deposition and impaired fibrinolysis may play a role in the pathophysiology of CRVO and require specific treatment.
Bandello
F
F
Department of Ophthalmology, University of Milano, Italy.
Viganò D'Angelo
S
S
Parlavecchia
M
M
Tavola
A
A
Della Valle
P
P
Brancato
R
R
D'Angelo
A
A
D000328:Adult; D000368:Aged; D001778:Blood Coagulation Disorders / Q000097:blood*; D005260:Female; D006801:Humans; D015994:Incidence; D016018:Least-Squares Analysis; D017270:Lipoprotein(a) / Q000097:blood*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012170:Retinal Vein Occlusion / Q000097:blood* / Q000453:epidemiology
D017270:Lipoprotein(a)