Kuhli-Hattenbach C, Miesbach W, Scharrer I, Hattenbach L-O
Klinik für Augenheilkunde, Universitätsklinikum Johann Wolfgang Goethe-Universität, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Deutschland.
Ophthalmologe. 2011 Feb;108(2):104-10. doi: 10.1007/s00347-010-2289-2.
Over the past years there has been a dramatic increase in the number of identifiable causes of thrombophilia. However, as retinal vein occlusions (RVO) have a strong pathogenic correlation with the presence of hypertension or arteriosclerosis and the average age of affected patients is usually within the sixth or seventh decade of life, thrombophilia screening of RVO patients poses a particularly difficult diagnostic challenge. It is clear that to use medical resources appropriately and improve the level of interdisciplinary patient care in RVO, subgroup analysis is required. Just recently, some studies have demonstrated the significant role of coagulation disorders in specific subgroups of RVO patients and have provided recommendations for clinical practice. These results indicate that thrombophilic risk factors are significantly more prevalent among patients equal or less than 45 years of age at the time of RVO or a previous thromboembolic event, among patients with a remarkable family history of thromboembolism prior to the age of 45 years, or among patients without cardiovascular risk factors. According to these data, thrombophilia screening should be considered in these selected subgroups.
在过去几年中,可识别的血栓形成倾向病因数量急剧增加。然而,由于视网膜静脉阻塞(RVO)与高血压或动脉硬化的存在有很强的致病相关性,且受影响患者的平均年龄通常在六七十岁,对RVO患者进行血栓形成倾向筛查提出了特别困难的诊断挑战。显然,为了合理利用医疗资源并提高RVO患者跨学科护理水平,需要进行亚组分析。最近,一些研究已经证明了凝血障碍在RVO患者特定亚组中的重要作用,并为临床实践提供了建议。这些结果表明,在发生RVO或既往血栓栓塞事件时年龄等于或小于45岁的患者中、在45岁之前有明显血栓栓塞家族史的患者中或在没有心血管危险因素的患者中,血栓形成倾向危险因素明显更为普遍。根据这些数据,应在这些选定的亚组中考虑进行血栓形成倾向筛查。