Risk Factors and Treatment Strategies in Patients With Retinal Vascular Occlusions

Clin Appl Thromb Hemost. 2015 Oct;21(7):672-7. doi: 10.1177/1076029613513320. Epub 2013 Dec 11.

Abstract

Retinal vein occlusion (RVO) and retinal artery occlusion (RAO) cause significant visual impairment. The role of thrombophilia and cardiovascular testing is uncertain, and optimal treatment strategies have not been determined. We reviewed medical records of 39 patients with RVO and RAO (23 women and 16 men). Thrombophilia and cardiovascular evaluations were performed and outcomes were reviewed. In all, 24 (61.5%) patients had at least 1 thrombophilia. Elevated factor VIII levels were found in RVO (n = 5) but not in RAO. There are no other significant differences in thrombophilias in RVO compared to those in RAO. Most patients had hypertension(41.2% RAO and 55% RVO) and hyperlipidemia (35.5% RAO and 81.8% RVO). In all, 4 women were using oral contraceptives, 2 were pregnant or postpartum. Follow-up data was available for 28 patients (13 RAO, 15 RVO). Nineteen were treated with aspirin, four with warfarin, and one with low molecular weight heparin. Eight patients reported improvement in vision at time of follow-up (5 RAO, 3 RVO). Multiple risk factors are associated with RVO and RAO, and a complete assessment should include thrombophilia and cardiovascular studies.

Keywords: aspirin; retinal vascular occlusion; thrombophilia; visual outcomes.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Aspirin / administration & dosage*
  • Female
  • Humans
  • Hyperlipidemias / blood
  • Hyperlipidemias / complications
  • Hyperlipidemias / drug therapy
  • Hypertension / blood
  • Hypertension / complications
  • Hypertension / drug therapy
  • Male
  • Middle Aged
  • Postpartum Period
  • Pregnancy
  • Pregnancy Complications / blood
  • Pregnancy Complications / drug therapy
  • Retinal Vein Occlusion / blood*
  • Retinal Vein Occlusion / drug therapy*
  • Retinal Vein Occlusion / etiology
  • Retrospective Studies
  • Risk Factors
  • Thrombophilia / blood
  • Thrombophilia / complications
  • Thrombophilia / drug therapy
  • Warfarin / administration & dosage*

Substances

  • Warfarin
  • Aspirin