Vielpeau I, Le Hello C, Legris A, Salsou E, Lecoq P J
Service d'Ophtalmologie, CHU de Caen, avenue de la Côte de Nacre, 14 000 Caen.
J Fr Ophtalmol. 2001 Nov;24(9):955-60.
The antiphospholipid syndrome is characterized by the association of antiphospholipid antibodies and occlusive vascular events. The ocular vascular damage is described in the literature and may reveal the syndrome. It's diagnosis is important because this disease, which generally affects young people, may endanger ocular and vital prognosis. Two cases are reported.
Two young people aged 22 and 32 presented with a sudden unilateral loss of vision. In both cases, fundus examination and fluorescein angiography revealed a severe retinal vascular occlusion. For one patient, an antiphospholipid syndrome was discovered during etiological check-up. for the second one, it was associated with a heterozygote state mutation of Leiden V factor. In both cases the visual function of the affected eye was lost.
In most cases central artery or vein occlusion means atherosclerosis. However, other etiologies must be studied in young patients. According to several studies: antiphospholipid syndrome has been detected in 5% to 33% of the patients showing a major vascular retinal obstruction. The association of thrombophilia must be considered because it increases the risk of thrombotic recurrence.
The antiphospholipid syndrome must be studied in cases of numerous and severe retinal vascular obstruction occurring in young patients, even if vascular risks exist. This diagnosis is important because it may imply a long-lasting anticoagulative or an antiaggregative treatment to significantly reduce the risk of recurrent thrombotic events.
抗磷脂综合征的特征是抗磷脂抗体与闭塞性血管事件相关。眼部血管损伤在文献中有描述，可能提示该综合征。其诊断很重要，因为这种通常影响年轻人的疾病可能危及眼部和生命预后。报告了两例病例。
两名分别为22岁和32岁的年轻人出现突然的单眼视力丧失。在这两例病例中，眼底检查和荧光素血管造影均显示严重的视网膜血管阻塞。其中一名患者在病因检查中发现患有抗磷脂综合征。另一名患者则与莱顿V因子杂合子状态突变有关。两例病例中患眼的视功能均丧失。
在大多数情况下，中央动脉或静脉阻塞意味着动脉粥样硬化。然而，年轻患者必须研究其他病因。根据多项研究：在表现为主要视网膜血管阻塞的患者中，5%至33%检测出抗磷脂综合征。必须考虑血栓形成倾向的关联，因为它会增加血栓复发的风险。
对于年轻患者出现大量严重视网膜血管阻塞的病例，即使存在血管风险，也必须研究抗磷脂综合征。这一诊断很重要，因为它可能意味着需要进行长期抗凝或抗聚集治疗，以显著降低复发性血栓事件的风险。
