Thrombophilic and cardiovascular risk factors for retinal vein occlusion

Background The role of thrombophilic and cardiovascular risk factors in different manifestations of retinal vein occlusion (RVO), i.e., central or branch RVO, and at different ages is still debated. Aims To evaluate the association between thrombophilic and cardiovascular risk factors and the risk of RVO (overall, separately for central and branch RVO, and at different ages). Methods Case-control study on 313 patients with a first objectively-confirmed RVO (216 central and 97 branch RVO) and 415 healthy individuals. Results Antithrombin, protein C or protein S deficiency (adjusted odds ratio [95%CI]: 15.60 [2.01–121]; p = 0.009), hyperhomocysteinemia (HHCy; 3.22 [1.38–7.49]; p = 0.007), high factor VIII (FVIII) levels (3.08 [1.20–7.89]; p = 0.019), factor V Leiden (2.93 [0.97–8.86]; p = 0.058) and the presence of at least one cardiovascular risk factor (1.79 [1.00–3.23]; p = 0.050) were associated with an increased risk of branch RVO. The association was weaker for central RVO, and limited to HHCy (2.15 [1.09–4.24]; p = 0.027) and high FVIII (1.99 [0.90–4.42]; p = 0.091). For HHCy, high FVIII and cardiovascular risk factors the association with the risk of RVO was stronger at an age > 50 years (3.41[1.29–8.99], p = 0.013; 2.57[1.00–6.68], p = 0.050; and 2.03[1.16–3.56], p = 0.013, respectively) than ≤ 50 years (1.93[0.85–4.36], p = 0.114; 1.67[0.54–5.12], p = 0.371; and 1.22[0.73–2.03], p = 0.454, respectively), whereas classic inherited thrombophilia (antithrombin, protein C or protein S deficiencies, factor V Leiden and prothrombin G20210A mutation) was slightly more prevalent at an age ≤ 50 years (1.62 [0.76–3.45], p = 0.210) than > 50 years (1.11[0.44–2.79], p = 0.833). Conclusions Thrombophilic and cardiovascular risk factors are associated with RVO, particularly branch RVO. The risk of RVO associated with HHCy, high FVIII and cardiovascular risk factors is higher at an older age.