Retinal Vein Occlusion Linked With Thrombophilia, Non Vascular Factors in Younger Patients

close up head of young patient fix in Tomography in Optical Coherence
close up head of young patient fix in Tomography in Optical Coherence (OCT) equipment.
Individuals older than 50 years with retinal vein occlusion have a higher prevalence of diabetes mellitus, dyslipidemia, and hypertension compared with younger patients.

Inherited thrombophilia and non vascular factors may be associated with retinal vein occlusion (RVO) in patients aged 50 years or younger, according to a study published in Archivos de la Sociedad Española de Oftalmología. Diabetes mellitus, dyslipidemia, and hypertension remain significantly higher RVO risk factors for individuals aged 50 years and older. 

Researchers conducted a 10-year study of 309 individuals (mean age 67.7±12.5 years, 161 men) diagnosed with RVO at a single center. A total of 25 participants were younger than 50 years. The team performed fundoscopy and angiography, and identified risk factors associated with RVO among the cohort. 

The team found that the prevalence of inherited thrombophilia was higher in individuals younger than 50 years compared with those older than 50 years (32.0% vs 11.4%; P =.005). They also determined that members of the younger cohort were more likely to have no vascular risk factors linked with RVO compared with individuals older than 50 years (50% vs 6%; P <.0001). The team observed hepatitis C, thalassemia minor, vasculitis, and Lyme disease in this subset of young patients without vascular risk factors.

“Inherited thrombophilia was more prevalent in RVO patients younger than 50 years while classic vascular risk factors (hypertension, dyslipidemia and diabetes mellitus), hyperhomocysteinemia and carotid atheromatosis were more prevalent in those over 50 years,” according to the investigators. “Based on our findings, we suggest performing a genetic thrombophilia study only in RVO patients aged <50 years.”

Study limitations include a single center design and a small sample size of participants younger than 50 years.

Reference

Sanlés González I, Napal Lecumberri JJ, Pérez-Montes R, Cerveró Varona A, Casado Rojo A, Hernández Hernández J. Retinal vein occlusion in patients under 50 years. Analysis of vascular risk factors, thrombophilia, carotid ultrasound findings and uncommon aetiologies. Arch Soc Esp Oftalmol (Engl Ed). Published online May 23, 2022. doi:10.1016/j.oftale.2021.12.002.