Retinal vascular occlusion: a window to diagnosis of familial and acquired thrombophilia and hypofibrinolysis, with important ramifications for pregnancy outcomes

Stephan G Dixon,1 Carl T Bruce,1 Charles J Glueck,1 Robert A Sisk,2,3 Robert K Hutchins,2,3 Vybhav Jetty,1 Ping Wang1 1Cholesterol, Metabolism, and Thrombosis Center, Jewish Hospital of Cincinnati, 2Cincinnati Eye Institute, 3Department of Ophthalmology, University of Cincinnati College of Medicine...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Dixon SG, Bruce CT, Glueck CJ, Sisk RA, Hutchins RK, Jetty V, Wang P
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	thrombophilia retinal vascular occlusion retinal vein occlusion retinal artery occlusion pregnancy outcomes. Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/5d65b2c2387849d88079cb9ca795815e
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:5d65b2c2387849d88079cb9ca795815e
record_format	dspace
spelling	oai:doaj.org-article:5d65b2c2387849d88079cb9ca795815e2021-12-02T06:15:58ZRetinal vascular occlusion: a window to diagnosis of familial and acquired thrombophilia and hypofibrinolysis, with important ramifications for pregnancy outcomes1177-5483https://doaj.org/article/5d65b2c2387849d88079cb9ca795815e2016-08-01T00:00:00Zhttps://www.dovepress.com/retinal-vascular-occlusion-a-window-to-diagnosis-of-familial-and-acqui-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Stephan G Dixon,1 Carl T Bruce,1 Charles J Glueck,1 Robert A Sisk,2,3 Robert K Hutchins,2,3 Vybhav Jetty,1 Ping Wang1 1Cholesterol, Metabolism, and Thrombosis Center, Jewish Hospital of Cincinnati, 2Cincinnati Eye Institute, 3Department of Ophthalmology, University of Cincinnati College of Medicine, Cincinnati, OH, USA Aim: Our specific aim was to document the pathoetiologic importance of thrombophilia among females presenting with severe ischemic retinal vein (RVO) or retinal artery (RAO) occlusion, without typical risk factors, and to emphasize that the ophthalmologists’ diagnosis of thrombophilia has important diagnostic and therapeutic downstream ramifications for nonocular thrombosis, including reproductive outcomes. Methods: We evaluated familial and acquired thrombophilia in 60 females with RVO (central RVO, n=52; branch RVO, n=8) and 16 with RAO (central RAO, n=11; branch RAO, n=5). They were referred by retinologists, without typical risk factors for RVO/RAO and/or severe ocular ischemic presentation. We focused on extraocular thrombotic events, particularly pregnancy complications, including unexplained spontaneous abortion, pre-eclampsia–eclampsia. Thrombophilia measurements in the 76 females were compared with 62 healthy normal females without ocular vascular occlusions (OVOs). Results: The 76 females with OVO were more likely than 62 normal female controls to have high homocysteine (24% vs 0%, P<0.0001), high anticardiolipin antibody (immunoglobulin M, 17% vs 3%, P=0.012), high (>150%) factor VIII (42% vs 11%, P<0.0001), and high (>150%) factor XI (22% vs 4%, P=0.004). Of the 76 females, 26 (34%) had ≥1 spontaneous abortion; 17 (22%) had ≥2 spontaneous abortions and/or pre-eclampsia–eclampsia. Compared to 62 healthy female controls, these 17 females with pregnancy complications had high homocysteine (29% vs 0%, P=0.0003), high anticardiolipin antibody immunoglobulin M (24% vs 3%, P=0.02), high factor VIII (38% vs 11%, P=0.02), and were marginally more likely to be heterozygous for the factor V Leiden mutation (19% vs 3%, P=0.058). Conclusion: In females lacking typical risk factors for retinal vascular occlusion or severely ischemic presentation, by diagnosing thrombophilia as an etiology for OVO, the ophthalmologist opens a window to family screening and preventive therapy, with particular relevance to pregnancy outcomes and venous thromboembolism. Keywords: thrombophilia, retinal vascular occlusion, retinal vein occlusion, retinal artery occlusionDixon SGBruce CTGlueck CJSisk RAHutchins RKJetty VWang PDove Medical Pressarticlethrombophiliaretinal vascular occlusionretinal vein occlusionretinal artery occlusionpregnancy outcomes.OphthalmologyRE1-994ENClinical Ophthalmology, Vol 2016, Iss Issue 1, Pp 1479-1486 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	thrombophilia retinal vascular occlusion retinal vein occlusion retinal artery occlusion pregnancy outcomes. Ophthalmology RE1-994
spellingShingle	thrombophilia retinal vascular occlusion retinal vein occlusion retinal artery occlusion pregnancy outcomes. Ophthalmology RE1-994 Dixon SG Bruce CT Glueck CJ Sisk RA Hutchins RK Jetty V Wang P Retinal vascular occlusion: a window to diagnosis of familial and acquired thrombophilia and hypofibrinolysis, with important ramifications for pregnancy outcomes
description	Stephan G Dixon,1 Carl T Bruce,1 Charles J Glueck,1 Robert A Sisk,2,3 Robert K Hutchins,2,3 Vybhav Jetty,1 Ping Wang1 1Cholesterol, Metabolism, and Thrombosis Center, Jewish Hospital of Cincinnati, 2Cincinnati Eye Institute, 3Department of Ophthalmology, University of Cincinnati College of Medicine, Cincinnati, OH, USA Aim: Our specific aim was to document the pathoetiologic importance of thrombophilia among females presenting with severe ischemic retinal vein (RVO) or retinal artery (RAO) occlusion, without typical risk factors, and to emphasize that the ophthalmologists’ diagnosis of thrombophilia has important diagnostic and therapeutic downstream ramifications for nonocular thrombosis, including reproductive outcomes. Methods: We evaluated familial and acquired thrombophilia in 60 females with RVO (central RVO, n=52; branch RVO, n=8) and 16 with RAO (central RAO, n=11; branch RAO, n=5). They were referred by retinologists, without typical risk factors for RVO/RAO and/or severe ocular ischemic presentation. We focused on extraocular thrombotic events, particularly pregnancy complications, including unexplained spontaneous abortion, pre-eclampsia–eclampsia. Thrombophilia measurements in the 76 females were compared with 62 healthy normal females without ocular vascular occlusions (OVOs). Results: The 76 females with OVO were more likely than 62 normal female controls to have high homocysteine (24% vs 0%, P<0.0001), high anticardiolipin antibody (immunoglobulin M, 17% vs 3%, P=0.012), high (>150%) factor VIII (42% vs 11%, P<0.0001), and high (>150%) factor XI (22% vs 4%, P=0.004). Of the 76 females, 26 (34%) had ≥1 spontaneous abortion; 17 (22%) had ≥2 spontaneous abortions and/or pre-eclampsia–eclampsia. Compared to 62 healthy female controls, these 17 females with pregnancy complications had high homocysteine (29% vs 0%, P=0.0003), high anticardiolipin antibody immunoglobulin M (24% vs 3%, P=0.02), high factor VIII (38% vs 11%, P=0.02), and were marginally more likely to be heterozygous for the factor V Leiden mutation (19% vs 3%, P=0.058). Conclusion: In females lacking typical risk factors for retinal vascular occlusion or severely ischemic presentation, by diagnosing thrombophilia as an etiology for OVO, the ophthalmologist opens a window to family screening and preventive therapy, with particular relevance to pregnancy outcomes and venous thromboembolism. Keywords: thrombophilia, retinal vascular occlusion, retinal vein occlusion, retinal artery occlusion
format	article
author	Dixon SG Bruce CT Glueck CJ Sisk RA Hutchins RK Jetty V Wang P
author_facet	Dixon SG Bruce CT Glueck CJ Sisk RA Hutchins RK Jetty V Wang P
author_sort	Dixon SG
title	Retinal vascular occlusion: a window to diagnosis of familial and acquired thrombophilia and hypofibrinolysis, with important ramifications for pregnancy outcomes
title_short	Retinal vascular occlusion: a window to diagnosis of familial and acquired thrombophilia and hypofibrinolysis, with important ramifications for pregnancy outcomes
title_full	Retinal vascular occlusion: a window to diagnosis of familial and acquired thrombophilia and hypofibrinolysis, with important ramifications for pregnancy outcomes
title_fullStr	Retinal vascular occlusion: a window to diagnosis of familial and acquired thrombophilia and hypofibrinolysis, with important ramifications for pregnancy outcomes
title_full_unstemmed	Retinal vascular occlusion: a window to diagnosis of familial and acquired thrombophilia and hypofibrinolysis, with important ramifications for pregnancy outcomes
title_sort	retinal vascular occlusion: a window to diagnosis of familial and acquired thrombophilia and hypofibrinolysis, with important ramifications for pregnancy outcomes
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/5d65b2c2387849d88079cb9ca795815e
work_keys_str_mv	AT dixonsg retinalvascularocclusionawindowtodiagnosisoffamilialandacquiredthrombophiliaandhypofibrinolysiswithimportantramificationsforpregnancyoutcomes AT brucect retinalvascularocclusionawindowtodiagnosisoffamilialandacquiredthrombophiliaandhypofibrinolysiswithimportantramificationsforpregnancyoutcomes AT glueckcj retinalvascularocclusionawindowtodiagnosisoffamilialandacquiredthrombophiliaandhypofibrinolysiswithimportantramificationsforpregnancyoutcomes AT siskra retinalvascularocclusionawindowtodiagnosisoffamilialandacquiredthrombophiliaandhypofibrinolysiswithimportantramificationsforpregnancyoutcomes AT hutchinsrk retinalvascularocclusionawindowtodiagnosisoffamilialandacquiredthrombophiliaandhypofibrinolysiswithimportantramificationsforpregnancyoutcomes AT jettyv retinalvascularocclusionawindowtodiagnosisoffamilialandacquiredthrombophiliaandhypofibrinolysiswithimportantramificationsforpregnancyoutcomes AT wangp retinalvascularocclusionawindowtodiagnosisoffamilialandacquiredthrombophiliaandhypofibrinolysiswithimportantramificationsforpregnancyoutcomes
_version_	1718399991365500928

Retinal vascular occlusion: a window to diagnosis of familial and acquired thrombophilia and hypofibrinolysis, with important ramifications for pregnancy outcomes

Ejemplares similares