Atherosclerotic and thrombophilic risk factors in patients with recurrent central retinal vein occlusion

PURPOSE. Atherosclerotic and thrombophilic risk factors may be causes of central retinal vein occlusion (CRVO). The aim of this study was to evaluate the prevalence of the aforesaid risk factors in patients with recurrent CRVOs and patients with a single episode of CRVO. METHODS. Seventeen patients with recurrent CRVO and 30 with a single episode of CRVO were enrolled. The atherosclerotic risk factors investigated were hypertension, diabetes, smoking, and dyslipidemia. Specific laboratory tests for the following thrombophilic markers were performed: homocystinemia (Hcy), lipoprotein (a), factor VIII, factor II G20210A and factor V G1691A polymorphisms, lupus anticoagulant, anticardiolipin antibodies, plasminogen activator inhibitor-1, and deficit of vitamins B6, B12, and folic acid. A multivariate analysis, adjusted for age, gender, traditional and thrombophilic risk factors, was performed. Statistical significance was set at p <= 0.05. RESULTS. Hypercholesterolemia, hypertriglyceridemia, fasting, and postmethionine hyperhomocysteinemia (HHcy) were more prevalent in recurrent CRVO patients (p< 0.001, p< 0.001, p= 0.006, and p= 0.005, respectively). At multivariate analysis, hypercholesterolemia (OR: 5.04, 95% CI 1.39-18.17; p= 0.025), hypertriglyceridemia (OR: 5.60, 95% CI 1.52-20.61; p= 0.017), fasting HHcy (OR: 5.77, 95% CI 1.39-23.89; p= 0.028), and postmethionine HHcy (OR: 10.88, 95% CI 2.50-47.42; p= 0.002) were found to be significantly associated with recurrent CRVO. CONCLUSIONS. Dyslipidemia and hyperhomocysteinemia are independent risk factors for the occurrence of recurrent CRVO. A complete assessment of atherosclerotic and thrombophilic risk factors is recommended in CRVO patients. In addition, the need for a specific treatment is suggested.