Central retinal vein occlusion associated with high blood levels of lipoprotein (a).: Is lipoprotein (a) a reliable marker for identification of predisposed individuals?

To report a case of central retinal vein occlusion (CRVO) associated with abnormal elevation of Lipoprotein (a) [Lp(a)] plasma levels, without local or systemic risk factors. A 74-year-old man was referred to our department for cataract surgery in his left eye, and his anamnesis was negative for systemic diseases. Two months later, the patient presented with sudden visual loss in his operated eye, and comprehensive ophthalmic examination was performed, including Fluorescein Angiography (FA) and Optical Coherent Tomography (OCT). Serum concentrations of anticardiolipin and antiphospholipids antibodies, homocysteine and Lp(a) were measured. Ophthalmoscopy showed the classic features of acute CRVO, FA and OCT confirmed the initial diagnosis. Blood tests were negative for hyperhomocysteinemia, anticardiolipin and antiphospholipids antibodies, and an abnormal Lp(a) plasma concentration of 1.7 g/L was found. The patient was sent to the internist for further investigation and treatment. Lp(a) can be an useful marker for early identification of predisposed individuals to CRVO and may be involved in its pathogenesis, presumably through its pro-atherogenic and antifibrinolytic action.