Antiphopholipid antibodie and retinal thromboi in patient without rik factor: a propective cae-control tudy

PURPOE: To determine the prevalence of antiphopholipid antibodie and other immunologic abnormalitie in patient with occluive retinal vacular event, exempt from conventional rik factor of retinal thromboi. METHOD: Forty patient with retinal vacular occluion (26 with retinal vein occluion, eight with arterial occluion, two with combined venou and arterial occluion, and four with venou occluion plu vaculiti), free of main accepted rik factor for retinal thromboi, were propectively creened for antiphopholipid antibodie (anticardiolipin-antibodie and lupu anticoagulant) and other immunologic abnormalitie. Fourteen patient were younger than 50 year. Prevalence and mean value of antiphopholipid antibodie (aPL) were compared with thoe in a homogeneou control group of 40 patient. REULT: The prevalence of antiphopholipid antibodie in the tudy group wa 22.5% (nine of 40). Comparion with control group prevalence (5% [two of 40]) howed a tatitically ignificant difference (P = .04). ix patient in the tudy group dicloed poitivity for IgG-anticardiolipin antibodie, one patient for IgM anticardiolipin antibodie, and two patient for both iotype IgG and IgM anticardiolipin antibodie. The antibody aay for lupu anticoagulant wa negative for all patient. Three patient were diagnoed a having primary antiphopholipid antibody yndrome and are undergoing ytemic anticoagulant therapy. Relevant immunologic abnormalitie were alo found (27.5% with antinuclear antibodie, 35% with elevation of circulating immune complexe, 35% with complement deficiency, 30% with poitive rheumatoid factor, and 17.5% with poitive C-reactive protein). Thirteen patient (32.5%) had more than four parameter altered. No ignificant aociation wa found between prevalence or mean value of anticardiolipin antibody and patient younger than 50 year. CONCLUION: The high prevalence of anticardiolipin antibodie in patient with vao-occluive retinopathy exempt from conventional rik factor, and the relevant diagnotic and therapeutic implication, lead u to recommend a ytematic earch for pecific antiphopholipid antibodie in uch patient.