Title: Retinal Vein Occlusion -Risk Factors in Younger Patients
Authors: Arun Kumar Ayoor, Ranjini Kotancheri, Swathi Karuppali, Anu Bhaskar, Hasna Hussain K N
DOI: https://dx.doi.org/10.18535/jmscr/v5i10.136
Abstract
Introduction: Retinal vein occlusion (RVO) accounts for a major cause of sudden visual impairment in the population. Many of the investigations often turn out futile especially in the young and evaluation to find out the risk factors are also limited. Role of rare factors like raised serum homocysteine and vasculitis have to be kept in mind in this group and the fact that venous occlusions usually precede the development of systemic risk factors should be emphasized.
Materials and Methods: 52 patients in the age group of 11 to 50 years with a diagnosis of retinal vein occlusion were studied and classified into ischemic central retinal vein occlusion (ICRVO), non-ischemic CRVO (NICRVO), branch retinal vein occlusion (BRVO) and hemi CRVO (HCRVO).The various risk factors were analyzed including ocular risk factors, systemic hypertension, diabetes mellitus, dyslipidemia, smoking, serum creatinine and presence of hyper homocysteinemia in each age group.
Results: Mean age was 38.45 with 56% males and 42% females. Out of 52 patients analyzed, 37 were in the age group of 41 to 50, 33 had dyslipidemia, 22 patients were hypertensives, 17 were having diabetes mellitus. Serum homocysteine was elevated in 3 patients below 30 years of age and it was found to be statistically significant ( p value <0.001). No association was found between cigarette smoking, high serum creatinine and RVO. Ocular risk factors present were primary open angle glaucoma in one patient and ocular hypertension in the other.
Conclusion: Detailed evaluation for systemic risk factors should be made mandatory in all cases of retinal vein occlusion. Many of the patients belonged to older age group and dyslipidemia was the major single modifiable risk factor among these. It should be kept in mind that in younger population, conventional metabolic risk factors may not be evident in the early stages and hence less common factors like high serum levels of homocysteine should be looked for and prompt treatment initiated at the earliest. Strict follow up of these patients for evaluation of any systemic diseases in the future should also be done.
Keywords: Retinal vein occlusion (RVO), branch retinal vein occlusion (BRVO), hypertension, diabetes mellitus, homocysteine, dyslipidemia, smoking, risk factors.
