title: The role of coagulation disorders in patients with retinal vein occlusion.
abstract: BACKGROUND
  The role of a hypercoagulable state in the pathogenesis of retinal vein occlusion (RVO) has not been conclusively established.
  
  
  OBJECTIVE
  To analyse the prevalence of thrombophilia in RVO.
  
  
  METHODS
  Prospective case-control study.
  
  
  METHODS
  All the patients diagnosed with RVO were referred to an Internal Medicine clinic and compared with sex- and age-matched individuals from a population-based cohort. Demographic, clinical and laboratory variables (including a thrombophilia panel) were analysed.
  
  
  RESULTS
  One hundred and seventy patients (93 men and 77 women; 68 ± 11 years) and 170 controls (80 men and 90 women; 67 ± 10 years) were included. RVO was peripheral in 113 cases. Genetic thrombophilia was detected in 13% of patients. Acquired thrombophilia was observed in 10% of cases and 4.7 % of controls (P < 0.01). Sixty-three percent of cases and 24.6% of controls had serum hyperhomocysteinemia (odds ratio [OR] 5.2, IC 95% 2.7-10.1; P < 0.0001) : In RVO patients aged <50 years (n = 11), 36.4% had genetic thrombophilia (P = 0.04), as well as 50% of those without vascular risk factors (n = 18; P = 0.01). Forty-one (24%) patients with RVO received antiplatelet agents and 13 (7.6%) were on anticoagulants due to preexistent atrial fibrillation.
  
  
  CONCLUSIONS
  We suggest that, in patients with RVO, hyperhomocysteinemia and antiphospholipid syndrome should be ruled out. Moreover, a study of genetic thrombophilia should only be considered in those aged <50 years or without cardiovascular risk factors. Antiplatelet therapy with aspirin is probably the treatment of choice of RVO, to reduce the overall vascular risk. Anticoagulation should only be considered in patients with high-risk thrombophilia.
authors.affiliation: From the Department of Internal Medicine and.
authors.forename: J J
authors.initials: JJ
authors.lastname: Napal
authors.affiliation: From the Department of Internal Medicine and.
authors.forename: S
authors.initials: S
authors.lastname: Neila
authors.affiliation: Department of Hematology, Hospital Marqués de Valdecilla-IDIVAL, RETICEF, University of Cantabria, Santander, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Pérez-Montes
authors.affiliation: From the Department of Internal Medicine and.
authors.forename: I
authors.initials: I
authors.lastname: Sierra
authors.affiliation: From the Department of Internal Medicine and.
authors.forename: S
authors.initials: S
authors.lastname: Ruiz
authors.affiliation: From the Department of Internal Medicine and hernandezjluis@gmail.com.
authors.forename: J L
authors.initials: JL
authors.lastname: Hernández
mesh_terms: D000368:Aged; D017152:Antibodies, Antiphospholipid / Q000097:blood; D000925:Anticoagulants / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use*; D016022:Case-Control Studies; D005260:Female; D006710:Homocysteine / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D015995:Prevalence; D011446:Prospective Studies; D012170:Retinal Vein Occlusion / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D019851:Thrombophilia / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology
chemical_list: D017152:Antibodies, Antiphospholipid; D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D006710:Homocysteine; D001241:Aspirin