title: Risk factors, antithrombotic treatment and outcome in retinal vein occlusion: an age-related prospective cohort study.
abstract: OBJECTIVE
  Antithrombotic treatment for retinal vein occlusion (RVO) is controversial, although RVO has been surmised as a predictor of a subsequent vascular event. We aimed to evaluate risk factors, the effects of antithrombotic therapy and the occurrence of subsequent vascular events in patients with a first episode of RVO, according to age of RVO onset.
  
  
  METHODS
  In this prospective cohort study, patients with central (CRVO) and branch RVO (BRVO) confirmed by fluorescein angiography were studied; they were divided according to age. Cardiovascular risk factors and thrombophilia were evaluated. Anticoagulants or aspirin were given for at least 3 months. Patients were followed every 6-12 months and vascular events were recorded.
  
  
  RESULTS
  One hundred CRVO and 32 BRVO patients were enrolled. Five of 60 (8.3%) patients <50 yr and 4/72 (5.5%) over 50 yr had a hereditary thrombophilic defect. One or more cardiovascular risk factors were found in 35 (58%) patients of the younger group, and in 66 (91%) of the older group (P < 0.001). Antithrombotic treatment led to both a satisfactory recanalization of occluded veins and visual acuity improvement especially in younger patients. Vascular events occurred in 19 (14%) cases after 4 ± 3.3 yr from RVO, more frequently in older than in younger patients (22% vs. 5%, P = 0.005).
  
  
  CONCLUSIONS
  Distribution of cardiovascular, but not of thrombophilic risk factors seems to be influenced by age in RVO patients. Patients with a first RVO, especially those >50 yr, are likely at risk of a subsequent vascular event.
authors: Clinical Medicine II, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy. mtsart@unipd.it
authors: Maria Teresa
authors: MT
authors: Sartori
authors: Sofia
authors: S
authors: Barbar
authors: Annalisa
authors: A
authors: Donà
authors: Stefano
authors: S
authors: Piermarocchi
authors: Elisabetta
authors: E
authors: Pilotto
authors: Graziella
authors: G
authors: Saggiorato
authors: Paolo
authors: P
authors: Prandoni
mesh_terms: D000328:Adult; D000368:Aged; D001778:Blood Coagulation Disorders / Q000150:complications; D002318:Cardiovascular Diseases / Q000150:complications; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012170:Retinal Vein Occlusion / Q000188:drug therapy* / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors
chemical_list: D005343:Fibrinolytic Agents