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David E. Fingerhut, Peng Zhao, Lucia Wolgast, Jacob Rand, Umar Mian; Inconsistency in laboratory testing in a subset of patients with Retinal Vein Occlusion (RVO): Bilateral disease or age 55 years or less. Invest. Ophthalmol. Vis. Sci. 2012;53(14):939.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the patterns of lab testing and abnormalities in patients with high risk of vascular or hematologic diseases with RVO.
Retrospective chart review for patients with ICD-9 code 362.35 & 36 at Montefiore Medical Center from 6/08 to 7/11. Patients were included if under age 56 years or with bilateral disease.
Of 232 patients with the diagnosis of RVO, 5%(11) had bilateral disease (bilateral) and 15% (35) were under 56 yrs (younger). In the younger group, 37% had CRVO, 25% had BRVO, and 6% had HRVO. In the bilateral group, out of 22 eyes, there were 5 (22.7%) CRVO, 10 (45.5%) BRVO, and 7 (31.8%) HRVO. With respect to coagulation testing, no labs were drawn in 3/35 (8.6%) of the younger and 5/11 (45.5%) of the bilateral. TABLE Other labs that were normal included: ANA, plasminogen, anticardiolipin (IgG/M), anti-thrombin III, factor V Leiden, protein C, protein S, and sickle cell trait. These tests were done in 3 to 20% of the younger patients.
In this series, a very high percentage of young patients had RVO. Hypertension (HTN) was the most common co morbidity in both groups and seen in only 1/3 of patients; hyperlipidemia and diabetes were next most common in the bilateral group and younger group, respectively. Two patients did not have any co-morbidities. None of the patients had any vasculitic or hematologic diseases. No consistent pattern of lab testing was asertained. Nearly all younger patients had some coagulation tests sent. Nearly 50% of bilateral disease had no thrombophilia testing performed. Most tests for specific diseases were negative. These results indicate a lack of standard approach to diagnostic testing and very poor test positivity. There is a need to develop a pertinent and standardized set of test for these patients.
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