From the Research
Antiphospholipid antibodies (APLA) are the most common thrombophilia associated with central retinal artery occlusion (CRAO), occurring in 38.1% of patients, according to the most recent study 1. This finding suggests that APLA plays a significant role in the pathogenesis of CRAO. In patients presenting with central retinal vein occlusion (CRVO) or CRAO, especially those under 50 years of age or with no traditional cardiovascular risk factors, thrombophilia screening should include APLA testing, as well as other important thrombophilias such as:
- Factor V Leiden
- Prothrombin gene mutation
- Protein C and S deficiencies
- Antithrombin deficiency Management of patients with APLA and ophthalmic thrombosis typically involves anticoagulation therapy, with duration depending on whether the thrombotic event was provoked or unprovoked. Patients may require lifelong anticoagulation if they have recurrent events or multiple thrombophilic factors. Regular ophthalmologic follow-up is essential to monitor for complications such as neovascularization or glaucoma. It is worth noting that while Factor V Leiden is a well-known thrombophilia, the most recent study 1 found that APLA was the most common thrombophilia in CRAO patients, highlighting the importance of considering APLA in the diagnostic workup. Additionally, other studies have found associations between CRVO and thrombophilias such as factor V Leiden, high factor VIII, and low antithrombin III 2, and between CRAO and thrombophilias such as low protein C, homocysteinemia, and lupus anticoagulant 2. However, the most recent and highest quality study 1 prioritizes APLA as the most common thrombophilia in CRAO.