Martínez F, Furió E, Fabiá M J, Pérez A V, González-Albert V, Rojo-Martínez G, Martínez-Larrad M T, Mena-Martín F J, Soriguer F, Serrano-Ríos M, Chaves F J, Martín-Escudero J C, Redón J, García-Fuster M J
Internal Medicine Department, Fundación de Investigación del Hospital Clínico de Valencia- INCLIVA, Hospital Clínico Universitario, Universidad de Valencia, Valencia, Spain; "Centro de Investigación Biomédica en Red (CIBER) de Fisiopatología, Obesidad y Nutrición (CIBEROB)", Institute of Health Carlos III, Minister of Health, Madrid, Spain.
Int J Clin Pract. 2014 Jul;68(7):871-81. doi: 10.1111/ijcp.12390. Epub 2014 Feb 18.
Retinal vein occlusion (RVO) is the most frequent retinal vascular disease after diabetic retinopathy in which arterial risk factors are much more relevant than venous factors. The objective was to evaluate the role of risk factors in the development of the first episode of RVO.
One hundred patients with RVO [mean age 56 years, 42% females and mean body mass index (BMI) 27.5 kg/m(2)] were recruited consecutively from the outpatient clinic of a tertiary hospital in Valencia (Spain). All subjects underwent clinical assessment including anthropometric and blood pressure measurements and laboratory test including homocysteine, antiphospholipid antibodies (aPLAs) and thrombophilia studies. In half of the subjects, a carotid ultrasonography was performed. Three control populations matched by age, sex and BMI from different population-based studies were used to compare the levels and prevalence of arterial risk factors. One cohort of young patients with venous thromboembolic disease was used to compare the venous risk factors.
Blood pressure levels and the prevalence of hypertension were significantly higher in the RVO population when compared with those for the general populations. There was also a large proportion of undiagnosed hypertension within the RVO group. Moreover, carotid evaluation revealed that a large proportion of patients with RVO had evidence of subclinical organ damage. In addition, homocysteine levels and prevalence of aPLAs were similar to the results obtained in our cohort of venous thromboembolic disease.
The results indicate that hypertension is the key factor in the development of RVO, and that RVO can be the first manifestation of an undiagnosed hypertension. Furthermore, the majority of these patients had evidence of atherosclerotic disease. Among the venous factors, a thrombophilia study does not seem to be useful and only the prevalence of hyperhomocysteinaemia and aPLAs is higher than in the general population.
视网膜静脉阻塞（RVO）是糖尿病视网膜病变之后最常见的视网膜血管疾病，其中动脉危险因素比静脉因素更为关键。本研究旨在评估危险因素在RVO首发事件发生过程中的作用。
连续纳入100例RVO患者[平均年龄56岁，42%为女性，平均体重指数（BMI）为27.5kg/m²]，这些患者来自西班牙巴伦西亚一家三级医院的门诊。所有受试者均接受了临床评估，包括人体测量和血压测量，以及实验室检查，包括同型半胱氨酸、抗磷脂抗体（aPLA）和血栓形成倾向研究。半数受试者接受了颈动脉超声检查。使用来自不同人群研究的、按年龄、性别和BMI匹配的三个对照组，比较动脉危险因素的水平和患病率。使用一组年轻的静脉血栓栓塞性疾病患者来比较静脉危险因素。
与普通人群相比，RVO人群的血压水平和高血压患病率显著更高。RVO组中也有很大一部分未确诊的高血压患者。此外，颈动脉评估显示，很大一部分RVO患者有亚临床器官损伤的证据。此外，同型半胱氨酸水平和aPLA患病率与我们静脉血栓栓塞性疾病队列中的结果相似。
结果表明，高血压是RVO发生的关键因素，且RVO可能是未确诊高血压的首发表现。此外，这些患者中的大多数有动脉粥样硬化疾病的证据。在静脉因素中，血栓形成倾向研究似乎并无用处，只有高同型半胱氨酸血症和aPLA的患病率高于普通人群。
