Clinical and laboratory features of hemostatic disorders in patients with retinal vein occlusion

Shelkovnikova TV1,2, Takhchidi KhP3, Volkov AN4, Shishlyannikova NYu
About authors

1 Novokuznetsk State Institute of Further Training of Physicians, Novokuznetsk, Russia

2 Kemerovo Regional Clinical Ophthalmological Hospital, Kemerovo, Russia

3 Pirogov Russian National Research Medical University, Moscow, Russia

4 Kemerovo Regional Clinical Hospital, Kemerovo, Russia

5 Kemerovo State Medical University, Kemerovo, Russia

Correspondence should be addressed: Tatiana Shelkovnikova
Pionerskiy bulvar, d. 10a, kv. 1, Kemerovo, Russia, 650066; moc.liamg@avokinvoklehs.t

Received: 2016-11-28 Accepted: 2016-12-10 Published online: 2017-01-19

The number of patients with retinal venous occlusions is increasing, especially among young people. Often, they have revealed a genetic predisposition to thrombosis. Risk factors for thrombosis are genetic resistance to activated protein C (RAPC), genetic defect in factor V (FV Leiden) and the presence of lupus anticoagulant (LA). In this study we analyze the dependence of the various parameters of hemostasis in patients with retinal vein occlusion (RVO) on the background of FV Leiden mutation and LA. A total of 150 patients (150 eyes) with RVO (mean age — 42 ± 10 years) were examined and divided into three groups. Group 1: patients with RVO, FV Leiden and LA (n = 12); group 2: patients with RVO and FV Leiden (n = 11) without LA; group 3: patients with RVO without FV Leiden and LA, selected from remaining 107 people for a comparable number of groups (n = 30). The control group was 50 people without RVO, but with hypertension. It was shown that RAPC index in patients with FV Leiden mutation and the LA has the less value (0,6 ± 0,01) on comparison to patients with RVO (1,50 ± 0,18) (p < 0,05). They also have enhanced V, VIII and von Willebrand factors and intravascular platelet activity. LA exacerbates endotheliosis in the microvasculature of the retina and in combination with FV Leiden mutation increases the thrombogenesis, participating in the pathogenesis of ischemic thrombosis of central retinal vein and its branches, which clinically manifested as retinal thrombo-hemorrhagic syndrome. The hemostasis regulation genes polymorphisms detection (as well as lupus anticoagulant detection) is recommended to clarify the diagnosis and selection of adequate therapy.

Keywords: retinal vein occlusion, activated protein C, resistance, FV Leiden mutation, lupus anticoagulant