Prisco Domenico, Marcucci Rossella
Department of Medical And Surgical Critical Area, Section of Clinica Medica Generale e Cliniche Specialistiche, University of Florence, Florence, Italy.
Pathophysiol Haemost Thromb. 2002 Sep-Dec;32(5-6):308-11. doi: 10.1159/000073587.
Retinal vein occlusion (RVO) is a relatively common disease, often associated with the presence of diseases related to internal medicine. It is well known that RVO is associated with common systemic vascular disorders such as hypertension, arteriosclerosis and diabetes. Several studies using hospital-based controls have shown an increased risk of RVO in patients with arteriopathy, or high levels of plasma glucose and arterial blood pressure. Patients are categorized into six types of RVO based on the site of occlusion and on the type of consequent vascular damage. Central retinal vein occlusion (CRVO) is the most frequently-occurring and clinically relevant type of RVO. In addition to the well-known classical risk factors, new haemostasis-related ones have been investigated in patients affected by CRVO. While data concerning a number of parameters remain contradictory, high levels of type 1 plasminogen activator inhibitor (PAI-1) and hyperhomocysteinemia appear to play a significant role in the pathogenesis of this disease. Although based on a limited number of studies, this new knowledge could eventually provide important indications regarding prognosis and therapeutic strategies. There is no established treatment for CRVO. Treatment consists primarily of managing any identified underlying systemic disease. The increasing role of hypercoagulability in patients with CRVO supports the use of antithrombotic drugs in the treatment of this disease. Vitamin treatment to correct hyperhomocysteinemia should also be taken into consideration. However, the approach to CRVO treatment with antithrombotic drugs is not evidence-based yet. There is urgent need of intervention trials to evaluate the role of these drugs in CRVO patients.
视网膜静脉阻塞（RVO）是一种相对常见的疾病，常与内科相关疾病并存。众所周知，RVO与常见的全身性血管疾病有关，如高血压、动脉硬化和糖尿病。多项以医院为对照的研究表明，患有动脉病变、血糖水平高或动脉血压高的患者发生RVO的风险增加。根据阻塞部位和随之而来的血管损伤类型，患者被分为六种类型的RVO。视网膜中央静脉阻塞（CRVO）是最常见且具有临床相关性的RVO类型。除了众所周知的经典危险因素外，还对受CRVO影响的患者研究了新的与止血相关的危险因素。虽然关于一些参数的数据仍然相互矛盾，但高水平的1型纤溶酶原激活物抑制剂（PAI-1）和高同型半胱氨酸血症似乎在这种疾病的发病机制中起重要作用。尽管基于有限数量的研究，但这一新知识最终可能为预后和治疗策略提供重要线索。目前尚无针对CRVO的确立治疗方法。治疗主要包括处理任何已确定的潜在全身性疾病。高凝状态在CRVO患者中的作用日益凸显，这支持在治疗该疾病时使用抗血栓药物。还应考虑采用维生素治疗来纠正高同型半胱氨酸血症。然而，使用抗血栓药物治疗CRVO的方法尚无循证依据。迫切需要进行干预试验来评估这些药物在CRVO患者中的作用。
