Factores de riesgo vascular y enfermedad obstructiva microvascular de la retina / Vascular risk factors and retinal occlusive disease

Fundamento y objetivo: Nuestro objetivo fue caracterizar el perfil de factores de riesgo vascular que presentan diferentes enfermedades vasculares oclusivas de la retina, como son la trombosis venosa, la embolia arterial y la neuropatía óptica isquémica anterior (NOIA). Para eso estudiamos a los pacientes que diagnosticó el servicio de oftalmología sobre la base de criterios clínicos, funduscópicos y angiográficos. Pacientes y método: Estudio transversal de 284 sujetos con enfermedades vasculares de la retina entre 25–93 años de edad a los que se seleccionó consecutivamente en la consulta de oftalmología y que se remitieron a la consulta de medicina interna. Resultados: De 284 pacientes, el 52 % eran varones y el 48 % eran mujeres, con una edad media (DE) de 62 (12) años (intervalo: 25–93 años). La trombosis venosa retiniana era la enfermedad más frecuente, con un 66 % (intervalo de confianza [IC] del 95%: 60,4–71,5), seguida de la NOIA, con un 21% (IC del 95%: 16,1–25,8) y la embolia arterial, con un 11% (IC del 95 %: 7,29–14,7). En conjunto, presentaban alta prevalencia de antecedentes de factores de riesgo vascular, sobre todo hipertensión arterial, en un 50 % (IC del 95%: 44,0–55,9), y síndrome metabólico en un 39% (IC del 95%: 33,2–44,7). Individualmente, la trombosis venosa retiniana se asoció a hipertensión arterial con hipertrofia ventricular izquierda en el 54% (p<0,009), y fue significativa (p<0,01) en la trombosis central respecto a las trombosis de ramas. Los enfermos con embolia arterial tenían menos sobrepeso y obesidad (p<0,04), pero presentaban significativamente (p<0,001) soplos vasculares y placas aterosclerosas en carótidas, así como enfermedad vascular extraocular. La NOIA va asociado a obesidad, sobrepeso y diabetes. No existían diferencias significativas en los marcadores inflamatorios (proteína C reactiva, factor de necrosis tumoral alfa, interleucina 6 e interleucina 10) en las diversas enfermedades retinianas (AU)

Background and objective: The aim of the present study is to define the risk factors associated with different retinal occlusive diseases, such as retinal venous thrombosis, arterial emboli and ischaemic anterior optic neuritis. Patients with any of these entities entered the study. Patients and method: A cross-sectional study on 284 consecutive subjects, aged 25–93, who were initially attended at the ophthalmology unit and then sent to the internal medicine unit. Results: We included 284 patients, 52% men, 48% women, aged 62±12 years (range 25–93). Retinal vein thrombosis was observed in 66% (IC 95%: 60.4–71,5), followed by anterior ischemic optic neuropathy in 21% (IC 95%: 16, 1–25,8) and arterial embolism in 11% (IC 95 %: 7,29–14,7). Vascular risk factors were frequently recorded, especially hypertension in 50% (IC 95%: 44, 0–55,9) and metabolic syndrome in 39% (IC 95%: 33,2–44,7). Venous thrombosis showed an association with hypertension and with left ventricular hypertrophy, especially central vein thrombosis (54%, p<0.009). Among those with arterial embolism obesity was less frequently observed (p=0.04), but these patients showed significantly (p<0.001) more vascular bruits, carotideal atheromatous plaques and extraocular vascular disease. Anterior optic ischaemic neuritis was significantly associated with obesity, overweight, and diabetes. No differences were observed regarding inflammatory markers (CRP, TNF alpha, IL-6 and IL-10) among the different retinal occlusive diseases analysed. Conclusions: Occlusive retinal diseases are associated with vascular risk factors, but the association is specific for each entity (AU)

[Vascular risk factors and retinal occlusive disease]. / Factores de riesgo vascular y enfermedad obstructiva microvascular de la retina.

BACKGROUND AND OBJECTIVE: The aim of the present study is to define the risk factors associated with different retinal occlusive diseases, such as retinal venous thrombosis, arterial emboli and ischaemic anterior optic neuritis. Patients with any of these entities entered the study. PATIENTS AND METHOD: A cross-sectional study on 284 consecutive subjects, aged 25-93, who were initially attended at the ophthalmology unit and then sent to the internal medicine unit. RESULTS: We included 284 patients, 52% men, 48% women, aged 62+/-12 years (range 25-93). Retinal vein thrombosis was observed in 66% (IC 95%: 60.4-71.5), followed by anterior ischemic optic neuropathy in 21% (IC 95%: 16.1-25.8) and arterial embolism in 11% (IC 95 %: 7.29-14.7). Vascular risk factors were frequently recorded, especially hypertension in 50% (IC 95%: 44. 0-55.9) and metabolic syndrome in 39% (IC 95%: 33.2-44.7). Venous thrombosis showed an association with hypertension and with left ventricular hypertrophy, especially central vein thrombosis (54%, p<0.009). Among those with arterial embolism obesity was less frequently observed (p=0.04), but these patients showed significantly (p<0.001) more vascular bruits, carotideal atheromatous plaques and extraocular vascular disease. Anterior optic ischaemic neuritis was significantly associated with obesity, overweight, and diabetes. No differences were observed regarding inflammatory markers (CRP, TNF alpha, IL-6 and IL-10) among the different retinal occlusive diseases analysed. CONCLUSIONS: Occlusive retinal diseases are associated with vascular risk factors, but the association is specific for each entity.