title: Ocular vascular thrombotic events: central retinal vein and central retinal artery occlusions.
abstract: We prospectively assessed associations of thrombophilia- hypofibrinolysis with central retinal vein occlusion (CRVO) (40 patients) and central retinal artery occlusion (CRAO) (9 patients). We used polymerase chain reaction measures for thrombophilia (factor V Leiden, prothrombin, C677T MTHFR, platelet glycoprotein PlA1/A2) and hypofibrinolysis (plasminogen activator inhibitor-1 4G4G). Serologic thrombophilia measures included protein C, protein S (total and free) and antithrombin III, homocysteine, lupus anticoagulant, anticardiolipin antibodies IgG-IgM, and factors VIII and XI. Serologic hypofibrinolysis measures included Lp(a) and plasminogen activator inhibitor activity. For comparison with 40 CRVO and 9 CRAO patients, 80 and 45 race-gender matched controls were studied. The factor V mutation was more common in CRVO (3/40, 8%) than controls (0/79, 0%), P = .036, as was high (>150%) factor VIII (12/40, 30%) versus (4/77, 5%), P = .0002. Low antithrombin III (<80%) was more common in CRVO (5/39, 13%) than in controls (2/73, 3%), P = .049. Homocysteine was high (> or =13.5 micromol/L) in 5/39 (13%) CRVO patients versus 2/78 controls (3%), P = .04. Three of 9 CRAO patients (33%) had low (<73%) protein C versus 2/37 controls (5%), P = .044. Two of 9 CRAO patients (22%) had high (> or =13.5 micromol/L) homocysteine versus 0/42 controls (0%), P =. 028. Four of 9 CRAO patients had the lupus anticoagulant (44%) versus 4/33 (12%) controls (P = .050). CRVO is associated with familial thrombophilia (factor V Leiden, factor VIII, low antithrombin III, homocysteinemia), and CRAO is associated with familial and acquired thrombophilia (low protein C, homocysteinemia, lupus anticoagulant), providing avenues for thromboprophylaxis, and triggering family screening.
authors.affiliation: Jewish Hospital Cholesterol Center, Cincinnati, OH 45229, USA. glueckch@healthall.com
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Glueck
authors.lastname: Ping Wang
authors.forename: Robert
authors.initials: R
authors.lastname: Hutchins
authors.forename: Michael R
authors.initials: MR
authors.lastname: Petersen
authors.forename: Karl
authors.initials: K
authors.lastname: Golnik
mesh_terms: D000328:Adult; D000368:Aged; D050197:Atherosclerosis / Q000097:blood / Q000209:etiology / Q000235:genetics; D016022:Case-Control Studies; D005165:Factor V / Q000235:genetics; D005260:Female; D005342:Fibrinolysis / Q000235:genetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000097:blood / Q000235:genetics; D011250:Pregnancy Complications, Hematologic / Q000097:blood / Q000235:genetics; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012161:Retinal Artery; D015356:Retinal Artery Occlusion / Q000097:blood / Q000209:etiology* / Q000235:genetics; D012170:Retinal Vein Occlusion / Q000097:blood / Q000209:etiology* / Q000235:genetics; D012307:Risk Factors; D019851:Thrombophilia / Q000097:blood / Q000150:complications / Q000235:genetics; D013927:Thrombosis / Q000097:blood / Q000209:etiology / Q000235:genetics
chemical_list: C095381:factor V Leiden; D005165:Factor V