Risk factors in central retinal vein occlusion: A multi-center case-control study conducted on the Italian population

2021 ◽  
pp. 112067212110644
Author(s):  
Trovato Battagliola Edoardo ◽  
Pacella Fernanda ◽  
Malvasi Mariaelena ◽  
Scalinci Sergio Zaccaria ◽  
Turchetti Paolo ◽  
...  

Purpose To explore the risk factors for central retinal vein occlusion (CRVO) by comparing a large sample of patients with healthy controls. Materials and Methods Multi-center case-control study. The study group includes patients affected by central retinal vein occlusion, confirmed angiographically, aged 50 years old or above (Group A). The control group includes healthy subjects without an history of retinal vein occlusion (Group B). Outcome measures: age, gender, active smoking, presence of uncontrolled arterial hypertension (uHTN), presence of the following comorbidities: diabetes mellitus type II (DMII), chronic liver disease (CLD), chronic kidney disease (CKD), thyroid disease (TD), systemic lupus erythematosus (SLE), hyperhomocystenemia (HHcy), dyslipidemia (DLip), carotid artery disease (CAD), glaucoma, atrial fibrillation (AF), migraine headache (MH), chronic obstructive pulmonary disease (COPD), obstructive sleep apnea syndrome (OSAS), history of myocardial infarction (MI). Odds-ratios were calculated with logistic regression analysis. Results A total of 203 patients (Group A) and 339 controls (Group B). Statistically-significant differences were found for the following variables: age (OR: 1.109 [1.081–1.138], p < .001), active smoking (OR: 2.048 [1.210- 3.466], p < .008), DMII (OR: 4.533 [2.097–9.803], p < .001), HHcy (OR: 4.507 [2.477–10.001 ], p < .001), DLip (OR: 2.255 [1.352–3.762], p  =  .002), CAD (OR: 6.632 [2.944- 14.942], p < .001), glaucoma (OR: 4.656 [2.031–10.673], < .001), OSAS (OR: 1.744 [1.023–2.975], < .041), uHTN (OR: 3.656 [2.247–5.949], < .001). No statistically-significant differences were found for the other variables. Conclusions Older age, active smoking, as well as presence of DMII, HHcy, DLip, CAD, glaucoma, OSAS, and uHTN, all increase the risk for CRVO. A comprehensive assessment of patients with CRVO is paramount. Adequate control of all the aforementioned risk factors is likely of great significance in reducing the incidence of CRVO among the general population, and it likely plays an important role in improving the prognosis following the occlusive event.

Author(s):  
Alan D. Penman ◽  
Kimberly W. Crowder ◽  
William M. Watkins

The Eye Disease Case-Control Study was a clinic-based, case-control study that investigated risk factors for 5 retinal diseases—branch retinal vein occlusion (BRVO), central retinal vein occlusion (CRVO), neovascular age-related macular degeneration (AMD), idiopathic macular hole, and rhegmatogenous retinal detachment—using a similar protocol and the same large pool of controls. An increased risk of BRVO was found in persons with a history of systemic hypertension, cardiovascular disease, increased body mass index at 20 years of age, a history of glaucoma, and higher serum levels of alpha 2 globulin. An increased risk of CRVO was found in persons with systemic hypertension, diabetes mellitus, and open-angle glaucoma. The authors recommended that patients with BRVO and CRVO should be evaluated for risk factors for cardiovascular disease (hypertension, hyperlipidemia, and diabetes), as well as for open-angle glaucoma.


PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260383
Author(s):  
Akinori Sato ◽  
Ryo Asaoka ◽  
Shin Tanaka ◽  
Koichi Nagura ◽  
Yui Tanaka ◽  
...  

Purpose To examine the usefulness of red channel fundus imaging to detect the ischemic status in eyes with central retinal vein occlusion (CRVO). Methods Ultra-widefield (UWF) fundus images were obtained from 42 eyes with CRVO. Twenty-one eyes were ischemic, and 21 eyes were non-ischemic. Rubeosis was found in 11 ischemic eyes. UWF images were split into red and green channels using ImageJ software. Both the color and red channel images were used to predict the presence or absence of ischemia when examined by masked graders. The sensitivity and specificity of UWF imagings for the detection of ischemia were calculated in Group A (total 42 eyes), Group B (32 eyes excluding non-rubeotic ischemic CRVO) and Group C (31 eyes excluding rubeotic ischemic CRVO), respectively. Moreover, a linear mixed model was conducted to investigate the relationship between the type of images and the accuracy of prediction in each group. Results No significant difference in the sensitivity of color fundus imaging was seen between Group A and Group B. By contrast, a significant difference in the sensitivity of red channel imaging was seen between Group A and Group B (p = 0.031). The accuracies of the predictions were not associated with the type of image in Group A and Group B, but were significantly associated in Group C (p = 0.026). Conclusions UWF red channel imaging enabled more accurate detection of the ischemic status, compared with color fundus images, especially in non-rubeotic CRVO eyes.


Author(s):  
Shivcharan Lal Chandravanshi, Sunil Kumar Shrivastava, Priyanka Agnihotri, Smriti Gupta

Aims and Objective - The aim of the present study is to identify risk factors associated with different retinal vascular occlusive diseases (RVOD), such as central retinal artery occlusion (CRAO), hemi-retinal artery occlusion (HRAO), branch retinal artery occlusion (BRAO), cilioretinal artery occlusion (Cilio-RAO), central retinal vein occlusion (CRVO), branch retinal vein occlusion (BRVO), and hemi-retinal vein occlusion (HRVO). Patients and Method - A cross-sectional study on 114 consecutive subjects, aged 24-96 years who have attended at the outpatient department of ophthalmology at Shyam Shah Medical College, Rewa, MP, were included in the study. The Duration of study was January 2016 to December 2017. Only patients with CRAO, BRAO, HRAO, Cilio-RAO, CRVO, BRVO, and HRVO were included in the study. Other retinal vascular disorders such as diabetic vaso-occlusive disease, anterior and posterior ischemic and non-ischemic neuropathy, hypertensive retinopathy, sickle cell retinopathy, retinal telangiectasia, retinopathy of prematurity, were excluded from study. Results - We have included 114 patients, 64 cases (56.14%) males, 50 (43.85%) females, aged 56+/-8 years (range 24-96 years).  Bilateral retinal vascular occlusive disorders were seen in only 4 cases (3.5%). Two patients have bilateral CRVO followed by one case of bilateral BRVO and one case of bilateral CRAO.  Out of 114 patients, branch retinal vein occlusion was seen in 62 cases (54.38%), followed by central retinal vein occlusion in 36 cases (31.57%), CRAO in 8 cases (7.01%), and hemi- retinal vein occlusion in 4 cases (3.50%). Hypertension was the most common, (40 cases, 35.08%) risk factor identified for retinal vascular occlusive disorders followed by diabetes 24 cases (21.05%), combined diabetes and hypertension in 22 cases (19.29%), and atherosclerosis in 18 cases (15.78%). Conclusions - Retinal vascular occlusive diseases have systemic as well as ocular risk factors. Understanding of these risk factors is essential for proper treatment of RVOD. Timely identification of risk factors for RVOD may helpful in decreasing ocular and systemic morbidity in these patients.


2020 ◽  
pp. 112067212096033
Author(s):  
Tony Y. Chen ◽  
Aditya Uppuluri ◽  
Marco A. Zarbin ◽  
Neelakshi Bhagat

Purpose: Several risk factors have been identified for central retinal vein occlusion (CRVO) in older population. CRVO in young is uncommon, and the risk factors for this group are unclear. This large retrospective, cross-sectional study used the National Inpatient Sample (NIS) database to evaluate the risk factors for CRVO in patients 18 to 40 years of age. Methods: The 2002 to 2014 NIS database was used. All patients 18 to 40 years of age with a primary diagnosis of CRVO were identified. Age- and gender-matched non-CRVO controls were randomly selected. The primary outcome was identification of risk factors for CRVO. Chi-square analysis and Firth logistic regression were performed with IBM SPSS 23 and R packages versions 3.4.3, respectively. p < 0.05 was considered significant. Results: A total of 95 weighted young CRVO patients were identified. The average age was 31.44 ± 6.41 years with no gender predilection. Systemic and ocular conditions found to have statistically significant associations with CRVO included primary open-angle glaucoma (POAG) (OR 836.72, p < 0.001), retinal vasculitis (OR 705.82, p < 0.001), pseudotumor cerebri (OR 35.94, p < 0.001), hypercoagulable state (OR 25.25, p < 0.001), history of deep vein thrombosis/pulmonary embolism (DVT/PE) (OR 21.88, p < 0.001), and hyperlipidemia (OR 3.60, p = 0.003). Conclusion: The most significant risk factors for CRVO in young adults were POAG, retinal vasculitis, and pseudotumor cerebri. Hypercoagulable states and DVT/PE were also associated with CRVO in this population. Systemic inflammatory conditions were not associated with CRVO. Traditional risk factors such as hypertension and diabetes did not pose significant risks, whereas hyperlipidemia was deemed a significant risk factor.


Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4959-4959
Author(s):  
Betty Y.Y. Cheung ◽  
Kiran Parmar ◽  
Ghasem Yadegarfar ◽  
Beverley J. Hunt ◽  
Claire N. Harrison

Abstract Introduction. Essential thrombocythemia (ET) is associated with an increased risk of thrombosis. Many patients are treated with anti-platelet agents and/or cytoreductive therapy in order to minimise the risk but some still develop thrombotic events. The PFA-100® is an effective near-patient platelet function analyser and the Thromboelastograph (TEG®) Haemostasis Analyser assesses global haemostasis in whole blood. The usefulness of these technologies has not been fully evaluated in ET. Patients and Methods. We compared results from the PFA-100® and TEG® in 25 ET patients and 19 controls. Overall the ET patients comprised 18 females and 7 males, their median age was 55 yrs, median platelet count 423x109/l. Twenty-two were on anti-platelet therapy (21 on 75mg aspirin, 1 on aspirin and clopidogrel). Seventeen patients were receiving cytoreductive therapy (10 hydroxyurea, 2 a-interferon, 4 busulphan and 1 busulphan with anagrelide). Eight patients had previous thrombosis (4 transient ischaemic attacks, 1 stroke, 1 central retinal vein occlusion, 2 multiple events [1 stroke, erythromelalgia and digital ischaemia; 1 central retinal vein occlusion and digital ischaemia]) and 2 had haemorrhagic events. Results. All had normal INR, APTT and fibrinogen levels. Using the PFA-100®, Collagen/ADP closure times were prolonged in 15 (60%) patients compared to normal controls, suggesting platelet dysfunction, which included both patients with previous bleeding episodes. Twenty (91%) patients on aspirin had prolonged Collagen/Epinephrine closure times but for 2 (9%) patients these were within the normal range indicating aspirin-resistance. Both these patients had a history of thrombosis whilst on aspirin alone. Using TEG®, ET patients when compared to controls, took longer to initiate and to reach maximal clot strength (significantly longer R and K times, p=0.001, p=0.012 respectively and smaller angle, p=0.01) but the developed clot had a higher tensile strength (larger MA, p=0.024). There was a positive correlation between fibrinogen levels and MA (r=0.54, p=0.006) as well as APTT with R time (r=0.437, p= 0.029). There was no correlation between platelet count or prior history of thrombosis with any PFA-100® or TEG® variables. Conclusion. Low-dose aspirin had biochemical efficacy as assessed by PFA-100® Collagen/Epinephrine closure times in most but not all ET patients. Further studies are necessary to assess whether Collagen/ADP times can identify those at risk of bleeding. In ET, the TEG® demonstrates slower formation but a higher tensile clot strength than controls. Larger studies are needed to fully evaluate these findings and their clinical relevance.


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