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年轻视网膜静脉阻塞患者的病因学因素

Etiological factors in young patients with Retinal Vein Occlusion.

作者信息

Nalcaci Serhad, Degirmenci Cumali, Akkin Cezmi, Mentes Jale

机构信息

Dr. Serhad Nalcaci, M.D. Ege University Faculty of Medicine, Department of Ophthalmology, Izmir, Turkey.

Dr. Cumali Degirmenci, M.D. Ege University Faculty of Medicine, Department of Ophthalmology, Izmir, Turkey.

出版信息

Pak J Med Sci. 2019 Sep-Oct;35(5):1397-1401. doi: 10.12669/pjms.35.5.546.

Abstract

OBJECTIVE

To present the etiological factors of patients with Retinal Vein Occlusion (RVO) under the age of 50 years.

METHODS

The study was conducted at Ege University Medicine Faculty Department of Ophthalmology. The clinical records of patients with RVO under the age of 50 seen between January 2014 and March 2018 were analyzed retrospectively. Forty patients comprised the study. Detailed ophthalmologic examination was performed. Past medical history, drug use, thrombophilic features, hyperviscosity syndromes and pathologies that may cause vasculitis were noted.

RESULTS

Forty patients, 22 (55%) male and 18 (45%) female, were included. Mean age was 41.6 ± 10.01 years. Mean intraocular pressure and best-corrected visual acuity were 16.8 ± 5.47mmHg and 0.76 ± 0.64 logMAR, respectively. Hyperhomocystenemia (15 patients, 37.5%), Behçet's disease (three patients, 7.5%), diabetes and/or hypertension (16 patients, 40%), methylenetetrahydrofolate reductase gene mutation (11 patients, 27.5%), prothrombin gene mutation (four patients, 10%) and factor V Leiden mutation (five patients, 12.5%) were present among the patients as etiological factor. Multiple etiological factors were detected in 11 (27.5%) patients. Factor V Leiden mutation and methylenetetrahydrofolate reductase gene mutation were detected in one patient (2.5%) with Behçet's disease. Four patients with diabetes and/or hypertension also had hyperhomocystenemia and one of them had additionally prothrombin gene mutation. Two patients with methylenetetrahydrofolate reductase gene mutation also had a factor V Leiden mutation and one of them had additionally a prothrombin gene mutation. Three patients with methylenetetrahydrofolate reductase gene mutation also had hyperhomocystenemia and one patient with prothrombin gene mutation also had methylenetetrahydrofolate reductase gene mutation.

CONCLUSIONS

Etiological factors that might result in RVO in young individuals should be investigated in detail. Targeted therapies may help to prevent development of new RVOs and potential vascular problems in other organs.

摘要

目的

阐述50岁以下视网膜静脉阻塞(RVO)患者的病因。

方法

本研究在伊兹密尔艾杰大学医学院眼科进行。回顾性分析2014年1月至2018年3月期间就诊的50岁以下RVO患者的临床记录。40例患者纳入研究。进行了详细的眼科检查。记录既往病史、药物使用情况、血栓形成倾向特征、高粘滞综合征以及可能导致血管炎的病理情况。

结果

纳入40例患者,其中男性22例(55%),女性18例(45%)。平均年龄为41.6±10.01岁。平均眼压和最佳矫正视力分别为16.8±5.47mmHg和0.76±0.64 logMAR。患者中的病因包括高同型半胱氨酸血症(15例,37.5%)、白塞病(3例,7.5%)、糖尿病和/或高血压(16例,40%)、亚甲基四氢叶酸还原酶基因突变(11例,27.5%)、凝血酶原基因突变(4例,10%)和因子V莱顿突变(5例,12.5%)。11例(27.5%)患者检测到多种病因。1例(2.5%)白塞病患者检测到因子V莱顿突变和亚甲基四氢叶酸还原酶基因突变。4例糖尿病和/或高血压患者也有高同型半胱氨酸血症,其中1例还存在凝血酶原基因突变。2例亚甲基四氢叶酸还原酶基因突变患者也有因子V莱顿突变,其中1例还存在凝血酶原基因突变。3例亚甲基四氢叶酸还原酶基因突变患者也有高同型半胱氨酸血症,1例凝血酶原基因突变患者也有亚甲基四氢叶酸还原酶基因突变。

结论

对于可能导致年轻人发生RVO的病因应进行详细调查。针对性治疗可能有助于预防新的RVO发生以及其他器官潜在的血管问题。

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