Factores de riesgo vascular y enfermedad obstructiva microvascular de la retina

Abstract

Background and objective The aim of the present study is to define the risk factors associated with different retinal occlusive diseases, such as retinal venous thrombosis, arterial emboli and ischaemic anterior optic neuritis. Patients with any of these entities entered the study. Patients and method A cross-sectional study on 284 consecutive subjects, aged 25–93, who were initially attended at the ophthalmology unit and then sent to the internal medicine unit. Results We included 284 patients, 52% men, 48% women, aged 62±12 years (range 25–93). Retinal vein thrombosis was observed in 66% (IC 95%: 60.4–71,5), followed by anterior ischemic optic neuropathy in 21% (IC 95%: 16, 1–25,8) and arterial embolism in 11% (IC 95 %: 7,29–14,7). Vascular risk factors were frequently recorded, especially hypertension in 50% (IC 95%: 44, 0–55,9) and metabolic syndrome in 39% (IC 95%: 33,2–44,7). Venous thrombosis showed an association with hypertension and with left ventricular hypertrophy, especially central vein thrombosis (54%, p<0.009). Among those with arterial embolism obesity was less frequently observed (p=0.04), but these patients showed significantly (p<0.001) more vascular bruits, carotideal atheromatous plaques and extraocular vascular disease. Anterior optic ischaemic neuritis was significantly associated with obesity, overweight, and diabetes. No differences were observed regarding inflammatory markers (CRP, TNF alpha, IL-6 and IL-10) among the different retinal occlusive diseases analysed. Conclusions Occlusive retinal diseases are associated with vascular risk factors, but the association is specific for each entity.