title: Thrombophilia and vascular risk factors in retinal vein occlusion.
abstract: BACKGROUND
  The importance of vascular risk factors (VRF) and hypercoagulable state in patients with retinal vein occlusion (RVO) has not been conclusively established.
  
  
  OBJECTIVE
  To analyze the relevance of VRF, prevalence of thrombophilia, and ultrasonography findings in the supra-aortic trunks in patients with RVO.
  
  
  METHODS
  A prospective study was performed of all the patients diagnosed of RVO referred to an Internal Medicine clinic. The clinical, laboratory (including a thrombophilia panel) and ultrasonographic variables were analyzed.
  
  
  RESULTS
  A total of 98 patients (56 men, 42 women) mean age 66 years, were studied. Hypertension and dyslipidemia were the most prevalent VRF. Of these, 24% had hyperhomocysteinemia and atherosclerotic plaques were detected in the supra-aortic trunks in 48%. RVO was peripheral in 69 and central in 29. Genetic thrombophilia was detected in 13% and it was acquired in 9%. Thrombophilia was observed in 50% of subjects aged <50 years and in 67% of those without VRF (P=.004). Seventy-seven percent received antiplatelet drugs. Seven were on anticoagulants due to atrial fibrillation, although this did not prevent the development of RVO. Anticoagulation treatment was initiated in 4 cases, this being maintained indefinitely in the three patients diagnosed with antiphospholipid syndrome.
  
  
  CONCLUSIONS
  In patients with RVO, it may be recommendable to control classical VRF and measure serum homocysteine levels. Our data also suggest that antiphospholipid syndrome should be ruled out and that a study of thrombophilia should only be considered in subjects aged <50 years or without VRF. Antiplatelet therapy with aspirin is the treatment of choice to reduce the overall vascular risk. Anticoagulation should only be considered in those patients with high-risk thrombophilias.
authors.affiliation: Servicio de Medicina Interna, Hospital Marqués de Valdecilla, Santander, Cantabria, Spain
authors.forename: J J
authors.initials: JJ
authors.lastname: Napal Lecumberri
authors.forename: C
authors.initials: C
authors.lastname: Sedano Balbas
authors.forename: J
authors.initials: J
authors.lastname: Cañal Villanueva
authors.forename: J L
authors.initials: JL
authors.lastname: Hernández Hernández
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000150:complications* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D012170:Retinal Vein Occlusion / Q000150:complications* / Q000628:therapy; D012307:Risk Factors; D019851:Thrombophilia / Q000150:complications* / Q000453:epidemiology*