Karska-Basta Izabella, Kubicka-Trzaska Agnieszka, Romanowska-Dixon Bozena, Undas Anetta
Katedra i Klinika Okulistyki i Onkologii Okulistycznej Uniwersytetu Jagielloriskiego Collegium Medicum w Krakowie Kierownik.
Klin Oczna. 2013;115(1):29-33.
To evaluate thrombophilia as a risk factor of retinal vein occlusion in comparison with a control group and a general polish population.
Fifty nine consecutive patients with retinal vein occlusion were enrolled in this study. The diagnosis of retinal vein occlusion was based on the presence of typical findings in the eye fundus, fluorescein angiography, and optical coherence Stomography. Control group consisted of 59 subjects matched for age, sex, body mass index (BMI), medications, and cardiovascular risk factors. In all patients the following thrombophilic factors were evaluated: factor V mutation, 20210A prothrombin mutation, MTHFR (methy-lenetetrahydrofolatereductase) mutation C677T, protein C and free protein S level, antithrombin activity, factor VIII activity, anty-beta2 glikoprotein I antibodies level, anticardiolipin antibodies level, the presence of lupus anticoagulant, total homocysteine concentration.
In both groups with retinal vein occlusion and control group a high incidence of factor V Leiden was observed: 10.2% and 15.6%, respectively. In one patient the presence of 20210A prothrombin mutation was noted and in one the deficiency of free S protein was observed. Antiphospholipid antibodies were present in 11.8% of cases and factor VIII concentration > 150% in 3% of patients with retinal vein occlusion. In 8.5% of patients with retinal vein occlusion genotype TT MTHFR was present. Hyper-homocysteinemia was found in 5 cases with retinal vein occlusion (8.5%) and in 7 in a control group (11.9%). In a venous blood of patients with retinal vein occlusion homocysteine level was lower by 14.5% as compared with a control group (9.4 [7.0-11.3] vs. 11.0 [9.4-12 .8] micromol/l, p = 0.001).
The results of thrombophilia screening in patients with retinal vein occlusion showed no statistical differences as compared with a control group matched for age, sex, and cardiovascular risk factors. However patients with retinal vein occlusion showed statistically significant lower serum homocysteine concentration as compared with a control group. Two times higher prevalence of factor V Leiden was observed in patients with retinal vein occlusion than in Polish general population.
为了评估血栓形成倾向作为视网膜静脉阻塞的一个风险因素，并与对照组和波兰普通人群进行比较。
本研究纳入了59例连续的视网膜静脉阻塞患者。视网膜静脉阻塞的诊断基于眼底的典型表现、荧光素血管造影和光学相干断层扫描。对照组由59名年龄、性别、体重指数（BMI）、用药情况和心血管风险因素相匹配的受试者组成。对所有患者评估了以下血栓形成倾向因素：因子V突变、凝血酶原20210A突变、亚甲基四氢叶酸还原酶（MTHFR）C677T突变、蛋白C和游离蛋白S水平、抗凝血酶活性、因子VIII活性、抗β2糖蛋白I抗体水平、抗心磷脂抗体水平、狼疮抗凝物的存在、总同型半胱氨酸浓度。
在视网膜静脉阻塞组和对照组中均观察到因子V莱顿突变的高发生率：分别为10.2%和15.6%。在1例患者中发现了凝血酶原20210A突变，在1例患者中观察到游离S蛋白缺乏。抗磷脂抗体在11.8%的病例中存在，因子VIII浓度>150%在3%的视网膜静脉阻塞患者中出现。在8.5%的视网膜静脉阻塞患者中存在MTHFR基因TT型。在5例视网膜静脉阻塞患者（8.5%）和7例对照组患者（11.9%）中发现高同型半胱氨酸血症。与对照组相比，视网膜静脉阻塞患者静脉血中的同型半胱氨酸水平低14.5%（9.4[7.0 - 11.3]对11.0[9.4 - 12.8]微摩尔/升，p = 0.001）。
视网膜静脉阻塞患者的血栓形成倾向筛查结果与年龄、性别和心血管风险因素相匹配的对照组相比无统计学差异。然而，与对照组相比，视网膜静脉阻塞患者的血清同型半胱氨酸浓度有统计学意义的降低。视网膜静脉阻塞患者中因子V莱顿突变的患病率比波兰普通人群高两倍。
