Summary
A series of coagulation parameters and lipoprotein(a) (Lp(a)) were explored in plasma
from 40 patients with central retinal vein occlusion (CRVO, non-ischemic type n =
12; ischemic type n = 28) free of local and systemic predisposing factors, 1 to 12
months after the acute event. Forty age- and sex-matched patients with cataract served
as controls. Prothrombin fragment 1.2 (FI.2), D-dimer, FVII:C - but not FVII: Ag -
were higher and fibrinogen was lower in CRVO patients than in controls. Patients with
non-ischemic CRVO had higher FI .2 and FVII:C and lower heparin cofactor II than patients
with ischemic CRVO. Lp(a) levels greater than 300 mg/1 were observed in 12 patients
with CRVO and in 4 controls (30% vs 10%, p <0.025). Patients with high Lp(a) - consistently
associated with the S2 phenotype - had higher FVII:C, FVII:C/Ag ratio, and fibrinogen
than the remaining CRVO patients. Plasma FI.2 and D-dimer correlated fairly in controls
(r = 0.41) and patients with normal Lp(a) levels (r = 0.55), but they did not in the
group of patients with high Lp(a) (r = 0.19), where the latter parameter was negatively
related to D-dimer (r = −0.55). There was no dependence of the abnormalities observed
on the time elapsed from vein occlusion. The findings of activated FVII and high FI.2,
D-dimer, and Lp(a) are not uncommon in patients with CRVO. Increased thrombin formation
with fibrin deposition and impaired fibrinolysis may play a role in the pathophysiology
of CRVO and require specific treatment
