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F Morena, P Sivera, AM Fea, R Levo, C Eandi, D Bertola, A Cottino, FM Grignolo; Hypercoagulable State In Young Italian Patients (<55yrs) With Central Retinal Vein Thrombosis . Invest. Ophthalmol. Vis. Sci. 2002;43(13):532.
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Purpose:The pathogenesis of thrombus formation in central retinal vein thrombosis is poorly understood. Recently some papers pointed out to higher prevalence of hypercoagulable states in patients with central retinal vein thrombosis (CRVO). This study was carried out to ascertain the role of hypercoagulable states in these patients. To reduce the influence of disturbing factors the analysis was performed in young (<55yrs) patients only.Methods: in the last 18 months we studied 24 patients (16 males and 8 females) with central retinal vein thrombosis (first episode or relapse), aged 18 to 56 y. Inherited and acquired risk factors for thromboembolic disease were studied. 22 young patients with deep vein thrombosis (DVT) were investigated and used as controls Results: One or more acquired risk factors was present in 21 patients out of 24 (87.5%) including: hypertension in 16 patients (66.6%); smoking in 11 patients (46%); hyperlipidemia in 11 patients (46%); obesity in 6 patients (25%), diabetes mellitus in two patients (8.0%) and autoimmune disease in three patients (12.5%). Six patients (25%) had inherited defects: two were APC resistance (33.3%), one was heterozygous for the prothrombin G20210A variant (16.6%) and three (50%) had mild hyperomocystinemia. Factor VIII plasma levels have been determined only in 13 patients. 4 had high Factor VIII levels (31%). All patients with an inherited defect also had at least an acquired one. Among the female patients, four (50%) were menopausal, one (12.5%) was on oral contraceptives and two (25%) suffered from an autoimmune disease. There was no significant difference in inherited defects prevalence between the CRVO group and the DVT group. Increased risk in the CRVO group was found for hypertension (p=0.001), hyperlipidemia (p=0.0088) and menopausal (p=0.04). Conclusion: Acquired vascular risk factors seem to play a more important role in central retinal vein thrombosis than inherited thrombophilia. These findings reinforce recommendation to diagnose and treat systemic hypertension, hyperlipidemia and consider use of exogenous estrogen in post menopausal women.
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