Diagnostic Dilemma in Sequential Branch Retinal Vein and Artery Occlusion

Consigli, Andrea; Roquelaure, Daniel; Souteyrand, Georges; Chizzolini, Carlo; Thumann, Gabriele; Chronopoulos, Argyrios

doi:10.1097/opx.0000000000000707

Cited by 3 publications

(2 citation statements)

References 29 publications

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“…22,26,27,32 APS has also been associated with central retinal vein occlusion, 7,23,27,32–46 branch retinal vein occlusion,, 24,25,34,37,41,45,47–51 central retinal artery occlusion and branch retinal artery occlusion, 37,43,52–58 or the coexistence of both arterial and venous bed thromboses in the same patient. 32,36,59–64 Venous stasis retinopathy, 65,66 vitreous 67,68 and intraretinal hemorrhages, 67 retinal vasculitis, 69,70 cotton wool spots, 67,71 neovascularization, 72 diffuse retinal periphlebitis, 73 choroidal infarction, 74 and unexplained choroidal embolization 75 were already described as case reports.…”

Section: Part II – Systematic Review Of Ophthalmological Manifestatiomentioning

confidence: 99%

Ophthalmologic manifestations in primary antiphospholipid syndrome patients: A cross-sectional analysis of a primary antiphospholipid syndrome cohort (APS-Rio) and systematic review of the literature

Franco

Medina

Balbi

et al. 2020

Lupus

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Objective There is a broad spectrum of eye involvement in antiphospholipid syndrome (APS). The majority of descriptions are presented as case reports that include mostly APS patients secondary to systemic lupus erythematosus (SLE), with no compelling evidence in primary APS (PAPS). This study aimed to describe ocular manifestations in our well-defined PAPS cohort (APS-Rio) and then perform a systematic literature review (SLR) of ocular manifestations in patients with APS or positivity to aPL without SLE. Methods We retrospectively analyzed PAPS patients followed at our outpatient clinics. All patients fulfilled Sydney APS classification criteria (2006). We evaluated them for ocular symptoms and previous ocular diagnoses. Antiphospholipid antibodies and clinical APS manifestations were compared between patients with and without ocular manifestations. For the SLR, electronic databases were searched up to November 2019. Results We studied 105 PAPS patients; 90.5% were female and 56.2% were Caucasian. We found ocular manifestations in 37.1% of our cohort. Thrombosis was the main criteria manifestation (95.2%) and lupus anticoagulant was the most prevalent antibody. Ophthalmologic diagnoses were present in 7 patients, with 5 having retinal vessels thromboses. Amaurosis fugax was the leading complaint, present in 30 patients. In the univariate analysis, amaurosis fugax was related to livedo (p = 0.005), Raynaud’s phenomenon (p = 0.048) and the presence of anticardiolipin antibody (≥40 GPL/MPL) (p = 0.041). Hemianopia was associated with arterial hypertension (p = 0.049). In the multivariate analysis, the only association found was between livedo and amaurosis fugax (OR 4.09, 95%CI 1.5–11.11, p = 0.006). Our SLR incorporated 96 articles of ocular manifestations in patients with PAPS or positivity to aPL without SLE. Ocular findings varied from 5 to 88%, including anterior and posterior segments, orbital and neuro-ophthalmologic changes. Conclusion There is little evidence on ocular manifestations in PAPS. We described an association between livedo and amaurosis fugax. Prospective studies are needed to promote the best treatment and avoid blindness in PAPS patients.

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Section: Part II – Systematic Review Of Ophthalmological Manifestatiomentioning

confidence: 99%

Ophthalmologic manifestations in primary antiphospholipid syndrome patients: A cross-sectional analysis of a primary antiphospholipid syndrome cohort (APS-Rio) and systematic review of the literature

Franco

Medina

Balbi

et al. 2020

Lupus

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“…Retinal artery occlusion (RAO) is a cause of ocular morbidity that mainly affects patients older than 60 years 1 but also occurs in young people 2 , 3 , and no proven therapy exists 4 , 5 . RAO is the blocking of trunks or branches of the retinal circulation, which leads to the ischemic infarction of the affected retinal tissue 6 , 7 .…”

Section: Introductionmentioning

confidence: 99%

Homocysteine in retinal artery occlusive disease: A meta-analysis of cohort studies

Huang

Yang

Duan

et al. 2017

Sci Rep

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Few studies have reported the relationship between retinal artery occlusion (RAO) and plasma homocysteine (Hcy) levels. Our goal was to evaluate the association between the plasma Hcy level and the risk of RAO disease. Several databases were searched for all published studies that involved Hcy and RAO. Six studies evaluated hyperhomocysteinemia (hHcy) in retinal artery occlusion patients and controls; the incidence of hHcy in patients with RAO was higher than the control and the pooled odds ratio (OR) was 6.64 (95% confidence interval (CI): 3.42, 12.89). Subgroup analyses showed that the ORs were 4.77 (95% CI: 2.69, 8.46) in Western countries, 22.19 (95% CI: 2.46, 200.37) in Asian countries, 9.70 (95% CI: 4.43, 21.20) in the age matched group, 11.41 (95% CI: 3.32, 39.18) in the sex matched group, 9.70 (95% CI: 4.37, 21.53) in the healthy control group, and 6.82 (95% CI: 4.19, 11.10) in the sample size >30. The mean plasma Hcy level from 5 case-control studies was higher than controls, and the weighted mean difference (WMD) was 6.54 (95% CI: 2.79, 10.29). Retinal artery occlusion is associated with elevated plasma Hcy levels. Our study results suggest that hHcy is probably an independent risk factor for RAO.

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Occlusion mixte de l’artère et de la veine centrale de la rétine révélant une maladie de Behçet

et al. 2016

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Diagnostic Dilemma in Sequential Branch Retinal Vein and Artery Occlusion

Cited by 3 publications

References 29 publications

Ophthalmologic manifestations in primary antiphospholipid syndrome patients: A cross-sectional analysis of a primary antiphospholipid syndrome cohort (APS-Rio) and systematic review of the literature

Ophthalmologic manifestations in primary antiphospholipid syndrome patients: A cross-sectional analysis of a primary antiphospholipid syndrome cohort (APS-Rio) and systematic review of the literature

Homocysteine in retinal artery occlusive disease: A meta-analysis of cohort studies

Occlusion mixte de l’artère et de la veine centrale de la rétine révélant une maladie de Behçet

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