Retinal vein occlusion: evaluation of “classic” and “emerging” risk factors and treatment

Abstract

Retinal vein occlusion (RVO) is the second most common retinal vein disease and an important cause of blindness and visual morbidity. Systemic risk factors are commonly associated with RVO, while unclear it is the role of the thrombophilic and coagulation disorders. To evaluate "classic" and "emerging" risk factors, and to establish a good treatment for RVO. Fifty patients, 31 males and 19 females, with RVO were selected for our study. RVO patients were divided into two groups: those with central retinal vein occlusion (CRVO) and those with branch retinal vein occlusion (BRVO). All patients were subjected to an anamnestic investigation and were tested for thrombophilia, coagulation disorders and hyperlipidemia. Treatment and prophylaxis were evaluated. We have named "classic" the systemic risk factors associated with RVO and "emerging" those risk factors, haemostasis related, not clearly associated with RVO. RVO occurs more commonly in patients aged over 50. "Emerging" risk factors were more frequent in CRVO, "classic" in BRVO. Hyperhomocysteinemia is the most common "emerging" risk factor related to RVO. 71.4% of tested patients had hypercholesterolemia. Treatment with LMWH would appear to be safe and effective, but the small number of patients considered not allow us a definitive evaluation of its efficacy. Although our study has shown the correlation between RVO and the "emerging" risk factors, more studies are necessary to better know the real role of thrombophilic and coagulation disorders in this disease and to determine a specific protocol for the treatment and prophylaxis of RVO.

Influence of diabetes and diabetes type on anatomic and visual outcomes following central rein vein occlusion

“…A structured, retrospective medical record review of all patients seen at the Beetham Eye Institute of the Joslin Diabetes Center from 1 January 2004 to 15 November 2008 was performed. The study was approved by the Joslin Diabetes Center Institutional Review Board prior to the review of the patients' records.…”

“…The systemic medical and ophthalmic risk factors evaluated included those published in previous studies: hypertension, DM, hyperlipidemia, cardiovascular disease, smoking history, open-angle glaucoma, and elevated intraocular pressure (IOP). 7,[12][13][14][15][16][17][18][19][20][21] The ophthalmic findings from all patients at the initial (visit I), 4-month (visit M; window ¼ 3-6 months), and final follow-up (visit F) were recorded. Data from the visit prior to development of CRVO were also recorded when available (visit P).…”

“…11 Multiple systemic and ocular conditions are associated with CRVO. 7,[12][13][14][15][16][17][18][19][20][21] Many studies have confirmed higher prevalence of diabetes mellitus (DM) in patients with CRVO. 16,[21][22][23][24] Co-existing DM is reported in 10-34% of patients with CRVO and may affect the natural history in this subgroup of patients.…”

An interesting case of rubeosis iridis with neovascular glaucoma in a young patient

“…5,6 In addition to these well-known classical risk factors, hyperhomocysteinemia appears to play a significant role in the pathogenesis of this disease, 6 and is considered the most common "emerging" risk factor related to RVO. 7 Rubeosis iridis is a well-known complication of ischemic CRVO, which if not treated in time may lead to neovascular glaucoma (NVG). 8 NVG is a severe form of glaucoma characterized by iris neovascularization, a closed anterior chamber angle, and extremely high intraocular pressures (IOP) along with severe ocular pain and poor vision.…”

Retinal vascular occlusion and polymorphisms in genes coding for components of vitamin K cycle

“…В то же время исследования последних лет показывают, что в развитии ОСС могут участвовать и генетические факторы. Однако о роли по-лиморфизма 1639G4A гена VKORC1 как генетического фактора в развитии ОСС начали говорить только в по-следние годы [9].…”