Antiphospholipid syndrome and antiphospholipid antibody profile in patients with retinal vein occlusion

Abstract

IntroductionData on prevalence, association with vascular risk factors, clinical management and outcome of antiphospholipid syndrome (APS) in retinal vein occlusion (RVO) are scarce. MethodsPatients diagnosed with RVO at a tertiary-care hospital, and two additional groups; population-based controls and patients with APS (RVO-APS) were studied. Prevalence, association with vascular risk factors, antiphospholipid antibody profile, clinical management, genetic thrombophilia profile, carotid ultrasound and outcome of RVO-APS patients were assessed and compared with controls. ResultsSome 331 consecutive patients with RVO and 281 controls were included. Overall, aPLs were more prevalent in RVO-patients than in controls (33, 10% vs. 12, 4.3%; adjusted OR 2.47; 95% CI 1.25–4.88; p = 0.009). Patients with RVO-APS showed a high-risk “aPL profile” (lupus anticoagulant or triple-positive). We did not find any difference regarding classic vascular risk factors, hyperhomocysteinemia, prior vascular events, and carotid plaque, in RVO-patients with or without APS. The phenotype of RVO-APS also differed from APS. Seven patients received anticoagulation and 24 were on low-dose aspirin. After a median follow-up of 62 months, 7 patients suffered a RVO relapse (4 of them had APLs) and no RVO-APS patient had a new thrombotic or vascular event outside the retina. ConclusionsaPLs were more prevalent in RVO-patients than in controls, and in all patients, APS was not associated with any connective-tissue disease. RVO in the setting of APS seems not only related to atherosclerosis, but also to the “aPL profile”. In most of our RVO-patients with APS, low-dose aspirin was effective to prevent new or recurrent thrombotic events outside the retinal vessels. In these patients, we suggest that RVO could behave as an organ-specific manifestation of APS.