Abstract
Thrombophilia is an alteration of hemostasis that increases the risk to venous or arterial thrombosis. This condition may be the underlying cause of retinal vein thrombosis. To study the presence of thrombophilia in patients with retinal vein thrombosis. Prospective study of 55 patients aged 22 to 86 years, with retinal vein thrombosis (central or branch). Antithrombin III, coagulant protein C, functional protein S, resistance to activated C protein, homocysteine, prothrombin G20210A gene, lupus anticoagulant and anticardiolipin antibodies were measured in all. Seventeen patients had thrombophilic markers (antiphospholipid syndrome in seven, hyperhomocysteinemia in six and resistance to protein C in three). Of these 17 patients, 53% had high blood pressure, 35% an abnormal serum lipid profile and 23% a personal history of thrombosis. The thrombosis was central in 12 (ischemic in four) and of a branch in five (ischemic in two). Thrombophilic markers must be assessed in patients with retinal vein thrombosis.
Highlights
Thrombophilia is an alteration of hemostasis that increases the risk to venous or arterial thrombosis
Thrombophilic markers must be assessed in patients with retinal vein thrombosis (Rev Méd Chile 2005; 133: 167-74). (Key Words: Activated protein C resistance; Antiphospholipid syndrome; Retinal vein occlusion; Thrombophilia)
Es de particular importancia investigar los antecedentes de trombosis venosas previas (4 casos) o de factores desencadenantes como: uso de anticonceptivos orales (2 casos de las 10 mujeres), el reposo prolongado, una cirugía reciente y trauma o embarazo, porque aumentan el riesgo de trombosis en pacientes con trombofilia (Tabla 1)
Summary
Thrombophilia is an alteration of hemostasis that increases the risk to venous or arterial thrombosis. Dentro de los sistémicos están: edad avanzada, hipertensión arterial (HTA), diabetes mellitus (DM) y síndrome de hiperviscosidad, que en forma aislada puede manifestarse como una oclusión venosa retiniana[2,3,4,5]. Existen publicaciones en que algunos casos de trombofilia se asociaron a aumento de PAI-1 (inhibidor del activador del plasminógeno) pero, en la actualidad, se sabe que forma parte del síndrome X (o síndrome de resistencia a la insulina), que se asocia a la hipertensión arterial, a la dislipidemia, y a la aparición de diabetes mellitus, todos factores sistémicos frecuentes en OCVR32,33. La aparición de trombofilia como etiología de trombosis retiniana venosa y arterial, hace necesario, por tanto, considerar su estudio, ya que puede dar lugar a diferentes acciones terapéuticas
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