title: Retinal arterial occlusions in the young: systemic associations in Indian population.
abstract: OBJECTIVE
  To determine the systemic associations in retinal arterial occlusions (RAO) in young Indian individuals less than 40 years of age.
  
  
  METHODS
  Case records of 32 patients (35 eyes) of less than 40 years, with non-traumatic RAO were analysed. All patients underwent detailed ophthalmic and systemic evaluation including hemogram, lipid profile, coagulation profile, vasculitis screening, carotid Doppler, echocardiogram.
  
  
  RESULTS
  In the study 21 were males and 11 were females. The age ranged from 11-39 years (Mean 27.6 ± 8.43). Nine (28%) patients were below 20 years of age. Among 35 eyes, 28 (80%) had central retinal artery occlusion (CRAO), three (8.6%) had branch retinal artery occlusion (BRAO), two (5.7%) each had cilio-retinal (CLAO) and hemi-retinal artery occlusion (HRAO). Vision ranged from no perception of light to 20/20. On systemic evaluation, in 21 (65.6%) patients a hypercoagulable state was responsible for the RAO. Conditions leading to a hypercoagulable state included hyperhomocysteinemia (21.9%), hyperlipidemia (15.6%), anticardiolipin antibody (6.2%), antiphospholipid antibody (6.2%), polycythemia, thrombocytosis, protein S deficiency, use of oral contraceptives and renal disorder (3.1% each). Six (18.7%) patients had cardiac valvular defects. Vasculitis screening was positive in three (9.4%) patients. Two (6.2%) had isolated systemic hypertension. In two (6.2%) patients no abnormality could be detected.
  
  
  CONCLUSIONS
  The systemic associations of RAOs in the Indian population were distinctly different from those reported in the Western population. Hyperhomocysteinemia was the commonest association found. Whereas associations reported in the Western population such as cardiac abnormalities, coagulation disorders, hemoglobinopathies and oral contraceptive use were uncommon.
authors.affiliation: Shri Bhagawan Mahavir Department of Vitreoretinal Diseases, Sankara Nethralaya, Chennai, India. dhanashreeratra@gmail.com
authors.forename: Dhanashree
authors.initials: D
authors.lastname: Ratra
authors.forename: Maneesh
authors.initials: M
authors.lastname: Dhupper
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002648:Child; D005260:Female; D006801:Humans; D020138:Hyperhomocysteinemia / Q000208:ethnology*; D007194:India / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D015356:Retinal Artery Occlusion / Q000175:diagnosis / Q000208:ethnology*; D012189:Retrospective Studies; D055815:Young Adult