Role of haemorheological factors in patients with retinal vein occlusion

Francesco Sofi; Lucia Mannini; Rossella Marcucci; Paola Bolli; Andrea Sodi; Barbara Giambene; Ugo Menchini; Gian Franco Gensini; Rosanna Abbate; Domenico Prisco

doi:10.1160/TH07-04-0247

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2007; 98(06): 1215-1219
DOI: 10.1160/TH07-04-0247

Blood Coagulation, Fibrinolysis and Cellular Haemostasis

Schattauer GmbH

Role of haemorheological factors in patients with retinal vein occlusion

Francesco Sofi

¹Department of Medical and Surgical Critical Care, Thrombosis Centre, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy; Center for the study at molecular and clinical level of chronic, degenerative and neoplastic diseases to DEvelop NOvel THErapies, University of Florence, Italy

,

Lucia Mannini

¹Department of Medical and Surgical Critical Care, Thrombosis Centre, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy; Center for the study at molecular and clinical level of chronic, degenerative and neoplastic diseases to DEvelop NOvel THErapies, University of Florence, Italy

,

Rossella Marcucci

¹Department of Medical and Surgical Critical Care, Thrombosis Centre, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy; Center for the study at molecular and clinical level of chronic, degenerative and neoplastic diseases to DEvelop NOvel THErapies, University of Florence, Italy

,

Paola Bolli

²Don Carlo Gnocchi Foundation, IRCCS, Florence, Italy

,

Andrea Sodi

³Department of Oto-Neuro-Ophthalmological Surgical Sciences, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

,

Barbara Giambene

³Department of Oto-Neuro-Ophthalmological Surgical Sciences, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

,

Ugo Menchini

³Department of Oto-Neuro-Ophthalmological Surgical Sciences, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

,

Gian Franco Gensini

¹Department of Medical and Surgical Critical Care, Thrombosis Centre, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy; Center for the study at molecular and clinical level of chronic, degenerative and neoplastic diseases to DEvelop NOvel THErapies, University of Florence, Italy

²Don Carlo Gnocchi Foundation, IRCCS, Florence, Italy

,

Rosanna Abbate

¹Department of Medical and Surgical Critical Care, Thrombosis Centre, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy; Center for the study at molecular and clinical level of chronic, degenerative and neoplastic diseases to DEvelop NOvel THErapies, University of Florence, Italy

,

Domenico Prisco

¹Department of Medical and Surgical Critical Care, Thrombosis Centre, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy; Center for the study at molecular and clinical level of chronic, degenerative and neoplastic diseases to DEvelop NOvel THErapies, University of Florence, Italy

› Author Affiliations

Abstract

Summary

Retinal vein occlusion (RVO) is an important cause of permanent visual loss. Hyperviscosity, due to alterations of blood cells and plasma components, may play a role in the pathogenesis of RVO. Aim of this case-control study was to evaluate the possible association between haemorheology and RVO. In 180 RVO patients and in 180 healthy subjects comparable for age and gender we analysed the whole haemorheological profile: [whole blood viscosity (WBV), erythrocyte deformability index (DI), plasma viscosity (PLV), and fibrinogen]. WBV and PLV were measured using a rotational viscosimeter, whereas DI was measured by a microcomputer-assisted filtrometer. WBV at 0.512 sec^-1 and 94.5 sec^-1 shear rates as well as DI, but not PLV, were found to be significantly different in patients as compared to healthy subjects. At the logistic univariate analysis,a significant association between the highest tertiles of WBV at 94.5 sec^-1 shear rate (OR:4.91,95%CI 2.95–8.17;p<0.0001),WBV at 0.512 sec^-1 shear rate (OR: 2.31, 95%CI 1.42–3.77; p<0.0001), and the lowest tertile of DI (OR: 0.18, 95%CI 0.10–0.32; p<0.0001) and RVO was found. After adjustment for potential confounders,the highest tertiles of WBV at 0.512 sec^-1 shear rate (OR: 3.23, 95%CI 1.39–7.48; p=0.006),WBV at 94.5 sec^-1 shear rate (OR: 6.74, 95%CI 3.06–14.86; p<0.0001) and the lowest tertile of DI (OR:0.20,95%CI 0.09–0.44,p<0.0001) remained significantly associated with the disease. In conclusion,our data indicate that an alteration of haemorheological parameters may modulate the susceptibility to the RVO, by possibly helping to identify patients who may benefit from haemodilution.

Keywords

Blood viscosity - haemodilution - haemorheology - retinal vein occlusion

Full Text

References

References
1 Klein R, Klein BE, Moss SE. et al. The epidemiology of retinal vein occlusion: the Beaver Dam Eye Study. Trans Am Ophthalmol Soc 2000; 98: 133-141.
2 Cugati S, Wang JJ, Rochtchina E. et al. Ten-year incidence of retinal vein occlusion in an older population: the Blue Mountains Eye Study. Arch Ophthalmol 2006; 124: 726-732.
3 Cugati S, Wang JJ, Knudtson MD. et al. Retinal vein occlusion and vascular mortality. Pooled data analysis of 2 population-based cohorts. Ophthalmology 2007; 114: 520-524.
4 Prisco D, Marcucci R, Bertini L. et al. Cardiovascular and thrombophilic risk factors for central retinal vein occlusion. Eur J Intern Med 2002; 13: 163-169.
5 Marcucci R, Bertini L, Giusti B. et al. Thrombophilic risk factors in patients with central retinal vein occlusion. Thromb Haemost 2001; 86: 772-776.
6 Gori AM, Marcucci R, Fatini C. et al. Impaired fibrinolysis in retinal vein occlusion: a role for genetic determinants of PAI-1 levels. Thromb Haemost 2004; 92: 54-60.
7 Marcucci R, Giusti B, Betti I. et al. Genetic determinants of fasting and post-methionine hyperhomocysteinemia in patients with retinal vein occlusion. Thromb Res 2003; 110: 7-12.
8 Ring CP, Pearson TC, Sanders MD. et al. Viscosity and retinal vein thrombosis. Br J Ophthalmol 1976; 60: 397-410.
9 Trope GE, Lowe GDO, McArdle BM. et al. Abnormal blood viscosity and haemostasis in long-standing retinal vein occlusion. Br J Ophthalmol 1983; 67: 137-142.
10 Peduzzi M, Debbia A, Guerrieri F. et al. Abnormal blood rheology in retinal vein occlusion. A preliminary report. Graefes Arch Clin Exp Ophthalmol 1986; 224: 83-85.
11 Wiek J, Schade M, Wiederholt M. et al. Haemorheological changes in patients with retinal vein occlusion after isovolaemic hemodilution. Br J Ophthalmol 1990; 74: 665-669.
12 Piermarocchi S, Segato T, Bertoja H. et al. Branch retinal vein occlusion: the pathogenetic role of blood viscosity. Ann Ophthamol 1990; 22: 303-311.
13 Arend O, Remky A, Jung F. et al. Role of rheologic factors in patients with acute central retinal vein occlusion. Ophthalmology 1996; 103: 80-86.
14 Remky A, Arend O, Jung F. et al. Haemorheology in patients with branch retinal vein occlusion with and without risk factors. Graefes Arch Clin Exp Ophthalmol 1996; 234: 8-12.
15 Williamson TH, Rumley A, Lowe GDO. Blood viscosity, coagulation, and activated protein C resistance in central retinal vein occlusion: a population controlled study. Br J Ophthalmol 1996; 80: 203-208.
16 Lip PL, Blann AD, Jones AF. et al. Abnormalities in haemorheological factors and lipoprotein (a) in retinal vascular occlusion: implications for increased vascular risk. Eye 1998; 12: 245-251.
17 Hansen LL, Wiek J, Wiederholt M. A randomised prospective study of treatment of non-ischaemic central retinal vein occlusion by isovolaemic haemodilution. Br J Ophthalmol 1989; 73: 895-899.
18 De Sanctis MT, Cesarone MR, Belcaro G. et al. Treatment of retinal vein thrombosis with pentoxyfilline: a controlled, randomized trial. Angiology 2002; 53: 35-38.
19 Glacet-Bernard A, Coscas G, Chabanel A. et al. A randomized, double-masked study on the treatment of retinal vein occlusion with troxerutin. Am J Ophthalmol 1994; 118: 421-429.
20 Cifkova R, Erdine S, Fagard R. et al.; ESH/ESC hypertension guidelines committee. Practice guidelines for primary care physicians: 2003 ESH/ESC Hypertension guidelines. Hypertension 2003; 21: 1779-1786.
21 Expert committee on the diagnosis and classification of diabetes mellitus.. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care 2003; 26: 5-20.
22 National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment in Panel III).. Third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) final report. Circulation 2002; 106: 3143-3421.
23 Ramakrishnan S, Grebe R, Singh M. et al. Evaluation of haemorheological risk factor profile in plasmacytoma patients. Clin Haemorheol 1999; 20: 11-19.
24 Houtsmuller AJ, Vermeulen JA, Klompe M. et al. The influence of ticlopidine on the natural course of retinal vein occlusion. Agents Actions Suppl 1984; 15: 219-229.
25 Muravyov AV, Yakusevich VV, Surovaya L. et al. The effect of simvastatin therapy on hemorheological profile in coronary heart disease (CHD) patients. Clin Hemorheol Microcirc 2004; 31: 251-256.
26 Leoncini G, Bruzzese D, Signorello MG. et al. Platelet activation by collagen is increased in retinal vein occlusion. Thromb Haemost 2007; 97: 218-227.
27 Jannsen MC, den Heijer M, Cruysberg JR. et al. Retinal vein occlusion: a form of venous thrombosis or a complication of atherosclerosis? A meta-analysis of thrombophilic factors. Thromb Haemost 2005; 93: 1021-1026.