Abstract
Abstract: :
Purpose:The role of antiphospholipid antibodies (APA) in ocular arterial and venous occlusive disease is discussed controversially (1,2). Therefore, the purpose of this study was to evaluate the prevalence of APA in these conditions. Methods:Over a period of 3.5 years (1/1999–8/2002) 410 patients (224 male, 186 female) with ocular occlusive disease presented to our tertiary care center. In 368 of these patients antiphospholipid antibodies could be obtained. Results:86 (23.4%) patients tested positive for APA, which compares to an average of 5% APA positive in the general population. There was no significant difference in the incidence of APA between patients with venous (20.6%) or arterial (25.5%) occlusive disease (analysis of variance). This included 93 patients with central retinal vein occlusion (18% APA pos), 67 with retinal branch vein occlusion (24 % APA pos), 41 with central retinal artery occlusion (22 % APA pos), 53 with retinal arterial branch occlusion (32 % APA pos), 71 with anterior ischemic optic neuropathy (23% APA pos), 12 with posterior ischemic optic neuropathy (33% APA pos) and 31 patients with amaurosis fugax (23% APA pos). Of these patients, only 1.9% were positive for lupus anticoagulant while 22 % were positive for anticardiolipin antibodies. Here, the IgG isotype was more frequent then the IgM– isotype. When patients with accepted main risk factors of retinal thrombosis such as arterial hypertension, hyperlipidemia or a hemodynamic relevant occlusion of the carotid artery were excluded, APA were still positive in 15.3% of 85 patients with no significant difference between arterial or venous retinal occlusions. Conclusions:APA have been increasingly identified as risk factors in systemic thromboembolic events (3). In our study, the high prevalence of APA confirms its relevance in ocular occlusive disorders. In contrast to systemic arterial and venous thrombosis, where lupus anticoagulant rather than anticardiolipin antibodies are a known risk factor (3), our patients with ocular occlusive disorders showed a higher prevalence of anticardiolipin antibodies. 1. Glacet–Bernard et al. Arch Opththalmol. 1994. 112 (6): 790–5 2.Coniglio et al. Thromb. Res. 1996. 83 (2): 183–8 3. Galli et al. Blood. 2003. 101:1827–1832
Keywords: vascular occlusion/vascular occlusive disease • retina • clinical (human) or epidemiologic studies: prevalence/incidence