Antiphospholipid antibodies: a risk factor for occlusive retinal vascular disorders. Comparison with ocular inflammatory diseases.
OBJECTIVE
To evaluate the prevalence of antiphospholipid antibodies (aPL) together with immunological characteristics of patients with occlusive retinal vascular disorders (ORVD) with and without risk factors (systemic arterial hypertension, diabetes mellitus, hyperlipidemia, and embolizing cardiac disease) for retinal occlusions compared to patients with ocular inflammatory diseases (OID) and healthy controls.


METHODS
Sixty-eight patients with ORVD, 45 patients with OID, and 49 healthy persons were prospectively studied. Serologic studies included determination of anticardiolipin antibodies, lupus anticoagulant, antinuclear antibodies (ANA), levels of complement 4 and 3, total hemolytic complement (CH100), and circulating immune complexes (CIC).


RESULTS
Elevated levels of aPL were detected in 16 (24%) patients with ORVD compared to 4 (9%) patients with OID (OR 3.15, p < 0.05) and 4 (8%) controls (OR 3.46, p < 0.05). No significant differences were seen in the prevalence of aPL comparing risk factor-positive patients with ORVD (8 of 33, 24%) to risk factor-free patients with ORVD (8 of 35, 23%). A higher frequency of positive ANA, elevated IgA, and increased CIC were detected in aPL positive patients with ORVD compared to patients with OID.


CONCLUSIONS
Detection of aPL in patients with ORVD may help determine which patients are eligible for prophylactic treatment. An immunologic profile characterized by high prevalence of ANA, CIC, and elevated IgA distinguishes ORVD patients with aPL from inflammatory ophthalmologic disorders.
Carbone
J
J
Department of Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain. carbone@teleline.es
Sánchez-Ramón
S
S
Cobo-Soriano
R
R
Seoane
E
E
Aparicio
M J
MJ
Ruiz-Tíscar
J L
JL
Rodríguez-Mahou
M
M
Rodríguez-Molina
J J
JJ
Sarmiento
E
E
Cortés
C
C
Fernández-Cruz
E
E
D017152:Antibodies, Antiphospholipid / Q000032:analysis*; D000936:Antigen-Antibody Complex / Q000032:analysis; D016736:Antiphospholipid Syndrome / Q000150:complications / Q000276:immunology* / Q000473:pathology; D003165:Complement System Proteins / Q000032:analysis; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D015356:Retinal Artery Occlusion / Q000150:complications / Q000276:immunology* / Q000473:pathology; D012170:Retinal Vein Occlusion / Q000150:complications / Q000276:immunology* / Q000473:pathology; D012307:Risk Factors; D014605:Uveitis / Q000150:complications / Q000276:immunology* / Q000473:pathology
D017152:Antibodies, Antiphospholipid; D000936:Antigen-Antibody Complex; D003165:Complement System Proteins