98th Annual Meeting DOG 2000

K 290

High prevalence of APC resistance in young adults with retinal vessel occlusion

C. Kuhli1 , I. Scharrer2 , F. Koch1

Purpose: Resistance to APC (activated protein C) is among the coagulation disorders which have been implicated in branch and central retinal vein and artery occlusion. However, since the results of several studies vary considerably, the exact role of APC-resistance as a risk factor of retinal vessel occlusion still remains a matter of controversy. In the current study we investigated the role of APC-resistance as a risk factor of retinal vessel occlusion with respect to patient age and cardiovascular disorders.

Methods: In our study, a cohort of 122 unselected patients was screened for coagulation disorders and compared to a control group of 99 healthy age- and sex-matched subjects. Both cohorts were subdivided into two age-groups (£ 45 and > 45 years). Statistical analysis of differences between corresponding groups was performed by the Chi-Square-test. Acceptable significance was recorded when P values were <0.05.

Results: APC-resistance was found to be present in 8 of 43 young patients (18.6%), but only in 4 of 56 (7.7%) young control subjects (p=0.042). In the subgroup of young patients without cardiovascular risk factors, the proportion of subjects with resistance to APC was 29%. In contrast, APC resistance was found to be present in 6 of 79 (7,6%) patients >45 yrs.

Conclusion: Our results indicate that APC-resistance is highly prevalent in young patients (£ 45 years of age) with retinal vessel occlusion, whereas there is no difference between elder patients and control subjects or the normal population. We therefore suggest that determination of resistance to APC should be part of the routine work-up in younger patients presenting with retinal vessel occlusion unassociated with other defined etiologies.

Klinik für Augenheilkunde1 und Medizinische Klinik I2, Klinikum der Johann-Wolfgang-Goethe-Universität, Theodor-Stern-Kai 7, D-60590 Frankfurt am Main