Hypertension and multiple cardiovascular risk factors increase the risk for retinal vein occlusions

Ponto, Katharina A.; Scharrer, I.; Binder, Harald; Korb, Christina; Rosner, Ann Kristin; Ehlers, Till O; Rieser, Nikola; Grübel, Nadja C; Rossmann, Heidi; Wild, Philipp S.; Feltgen, Nicolas; Pfeiffer, Norbert; Mirshahi, Alireza

doi:10.1097/hjh.0000000000002057

Cited by 38 publications

(35 citation statements)

References 53 publications

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“…From this large study population, we drew age-and sex-matched populationbased controls. In accordance with the literature, demonstrating systemic risk factors to be relevant for RVO [3,4,47], the distribution of cardiovascular risk factors such as dyslipoproteinaemia, arterial hypertension, or obesity was increased in our RVO study population in comparison with the non-RVO ageand sex-matched controls. e multivariable regression analysis showed that the detected AABs were independent of the presented cardiovascular risk factors.…”

Section: Strengths and Limitationssupporting

confidence: 92%

Results from the Population-Based Gutenberg Health Study Revealing Four Altered Autoantibodies in Retinal Vein Occlusion Patients

Bell

Beutgen

Nickels

et al. 2020

Journal of Ophthalmology

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Purpose. Retinal vein occlusion (RVO) is the second most common retinal vascular disease and a major cause of visual impairment. In this study, we aimed to observe whether RVO cases have different antibody profiles as a new potential risk factor and whether a conversion of retinal vein occlusion (RVO) to neovascular glaucoma (NVG), one of the major complications, is occurring within a 5-year timeframe. Methods. We performed a nested case-control study (1 : 4) within the Gutenberg Health Study (GHS), a population-based, prospective cohort study in the Rhine-Main Region of Germany including 15,010 participants. RVO subjects (n = 59) were identified by grading of fundus photographs. Optic nerves of RVO subjects and age- and sex-matched controls (n = 229) at baseline and their follow-up examination after 5 years were analyzed for glaucomatous alterations. Of all RVO subjects and controls, serum autoantibody profiles were measured using in-house manufactured antigen-antibody microarrays. Results. Of the 59 RVO patients, 3 patients (5%) showed glaucomatous optic disc alterations at baseline, whereas no new glaucoma case was detected at 5-year follow-up. Four of the autoantibodies measured (against dermcidin, neurotrophin-3, superoxide dismutase 1, and signal recognition particle 14 kDa protein) were significantly increased in the serum of RVO patients p<0.001. Multivariable conditional logistic regression analysis showed that 3 of these 4 antibodies were independent of cardiovascular risk factors. Conclusions. We found several autoantibodies associated with RVO, targeting proteins and structures possibly involved in RVO pathogenesis.

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Section: Strengths and Limitationssupporting

confidence: 92%

Results from the Population-Based Gutenberg Health Study Revealing Four Altered Autoantibodies in Retinal Vein Occlusion Patients

Bell

Beutgen

Nickels

et al. 2020

Journal of Ophthalmology

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“…This twofold pathogenic activity of Lp(a) may be especially relevant in a condition like RVO which is on the border between venous and arterial thrombosis. [1][2][3][4][5] Based on our results, lowering Lp(a) represents an attractive approach to the prevention of RVO or its recurrence. Currently, the only recommended strategy to reduce Lp(a) remains plasma apheresis (expected reduction 60-80%) as there are no drugs able to selectively reduce Lp(a) levels, although some reduction has been reported with aspirin (15-20%), lomitapide and mipomersen (30%), PCSK9-inhibitors (30%), and nicotinic acid (38%).…”

Section: Discussionmentioning

confidence: 84%

“… 2 Unlike other vein thromboses, thrombophilia does not seem to play a major role in RVO, a conclusion supported by a recent meta-analysis which questioned the role of thrombophilia in retinal arterial and venous occlusive disease. 3 On the other hand, several common cardiovascular risk factors, such as hypertension, diabetes, and hyperlipemia, were reported to be predisposing factors for RVO 4 and to enhance the risk of RVO recurrence. 2 4 These findings suggest that although RVO is a venous thrombosis it has more characteristics in common with atherosclerosis than with venous thromboembolism (VTE).…”

Section: Introductionmentioning

confidence: 99%

Role of Increased Lipoprotein (a) in Retinal Vein Occlusion: A Systematic Review and Meta-analysis

Paciullo

Giannandrea

Virgili

et al. 2021

TH Open

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Background Increased lipoprotein (a) [Lp(a)] has been associated with enhanced risk of cardiovascular events and more recently with venous thromboembolism. However, there is inconclusive data on the association between enhanced Lp(a) and retinal vein occlusion (RVO). We aimed to assess the role of Lp(a) in RVO. Methods We performed a systematic review and meta-analysis of the studies addressing the role of Lp(a) in RVO. A systematic literature search was performed to identify all published papers reporting Lp(a) levels. Main outcome measures consisted of Lp(a) levels in patients with (cases) or without (controls) RVO. Results We included 13 studies for a total of 1,040 cases and 16,648 controls. Lp(a) levels above normal limits were associated with RVO (OR 2.38, 95% CI 1.7–3.34) and patients with RVO had higher Lp(a) levels than controls (weighted mean difference: 13.4 mg/dL, 95% CI 8.2–18.6). Conclusion Increased Lp(a) levels associate with RVO and should be included among diagnostic and prognostic indexes for this unusual-site vein thrombosis. Therapeutic interventions aimed to lower Lp(a) should be tested in RVO patients.

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“…In addition to systemic risk factors such as hypertension, hyperlipidemia, thrombofilia [23], diabetes mellitus, cerebral vascular stroke or cigarette smoking, the main ocular risk factors for RVO are glaucoma and ocular hypertension [24]. It has been previously demonstrated that macular vascular density (VD) in patients with glaucoma is significantly lower in both superficial and deep capillary plexus compared to healthy eyes [25].…”

Section: Discussionmentioning

confidence: 99%

A Novel Automatic Method to Estimate Visual Acuity and Analyze the Retinal Vasculature in Retinal Vein Occlusion Using Swept Source Optical Coherence Tomography Angiography

Díez-Sotelo

Díaz

Abraldes

et al. 2019

JCM

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The assessment of vascular biomarkers and their correlation with visual acuity is one of the most important issues in the diagnosis and follow-up of retinal vein occlusions (RVOs). The high workloads of clinical practice make it necessary to have a fast, objective, and automatic method to analyze image features and correlate them with visual function. The aim of this study is to propose a fully automatic system which is capable of estimating visual acuity (VA) in RVO eyes, based only on information obtained from macular optical coherence tomography angiography (OCTA) images. We also propose an automatic methodology to rapidly measure the foveal avascular zone (FAZ) area and the vascular density (VD) in the superficial and deep capillary plexuses in swept-source OCTA images centered on the fovea. The proposed methodology is validated using a representative sample of 133 visits of 50 RVO patients. Our methodology estimates VA with very high precision and is even more accurate when we integrate depth information, providing a high correlation index of 0.869 with the real VA, which outperforms the correlation index of 0.855 obtained when estimating VA from the data obtained by the semiautomatic existing method. In conclusion, the proposed method is the first computational system able to estimate VA in RVO, with the additional benefits of being automatic, less time-consuming, objective and more accurate. Furthermore, the proposed method is able to integrate depth information, a feature which is lacking in the existing method.

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Hypertension and multiple cardiovascular risk factors increase the risk for retinal vein occlusions

Cited by 38 publications

References 53 publications

Results from the Population-Based Gutenberg Health Study Revealing Four Altered Autoantibodies in Retinal Vein Occlusion Patients

Results from the Population-Based Gutenberg Health Study Revealing Four Altered Autoantibodies in Retinal Vein Occlusion Patients

Role of Increased Lipoprotein (a) in Retinal Vein Occlusion: A Systematic Review and Meta-analysis

A Novel Automatic Method to Estimate Visual Acuity and Analyze the Retinal Vasculature in Retinal Vein Occlusion Using Swept Source Optical Coherence Tomography Angiography

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