ESTADOS DE HIPERCOAGULABILIDAD Y OBSTRUCCION DE LA VENA CENTRAL DE LA RETINA

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La obstrucción de la arteria central de la retina puede producirse por varias condiciones patológicas establecidas. Los estados de hipercoagulabilidad no son habituales, por lo que sólo se justifica su investigación en pacientes con determinadas características.
lahey9.jpg Autor:
Cheung m
Columnista Experto de SIIC
Artículos publicados por Cheung m
Coautor
Marsha C. Cheung M.D.* 
Department of Ophthalmology, University of California at San Francisco, San Francisco, CA*
Recepción del artículo
12 de Febrero, 2004
Primera edición
30 de Julio, 2004
Segunda edición, ampliada y corregida
7 de Junio, 2021

Resumen
La obstrucción de la vena central de la retina (OCVR) es una causa común de pérdida grave de la visión. El examen de todos los pacientes con OVCR incluye evaluación de hipertensión, diabetes, hiperlipidemia, glaucoma y aterosclerosis. Los pacientes sin factores de riesgo habituales a menudo son sometidos a una evaluación extensa para descartar estados de hipercoagulabilidad. Hemos revisado la bibliografía actual respecto de cuáles trombofilias están asociadas con obstrucción de la vena central de la retina. La información presente sugiere que las pruebas de anticuerpos antifosfolípidos e hiperhomocisteinemia se asocian con más recurrencia de OVCR. No se recomiendan las pruebas indiscriminadas de detección de estados hipercoagulables en todos los pacientes con OVCR. Se debe considerar la investigación de estados hipercoagulables en ciertos grupos de pacientes que presentan OVCR, incluyendo a aquellos que son jóvenes y sin factores de riesgo conocidos, los que tienen antecedente familiar de trombosis a edad temprana y los que tienen enfermedad retiniana oclusiva venosa bilateral. La selección cuidadosa de pacientes aumenta la probabilidad de obtener pruebas positivas.

Palabras clave
Estados de hipercoagulabilidad, trombofilia, obstrucción de la vena central de la retina, trombosis venosa, enfermedad retiniana venosa oclusiva


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Abstract
Central retinal vein occlusion (CRVO) is a common cause of severe vision loss. Workup for all patients who present with CRVO includes evaluation for hypertension, diabetes, hyperlipidemia, glaucoma, and atherosclerosis. Those patients without the common risk factors are often subjected to extensive evaluation for hypercoagulable states. We review the current literature regarding which thrombophilias are actually associated with central retinal vein occlusion. Current data suggests that tests for antiphospholipid antibodies and hyperhomocysteinemia are most often associated with CRVO. Widespread screening for hypercoagulable states on all patients with CRVO is not recommended. A hypercoagulable state workup should be considered in certain groups of patients presenting with CRVO including those patients who are young without known risk factors, those with a positive family history for thrombosis at an early age, and/or those with recurrent or bilateral retinal venous occlusive disease. Careful patient selection increases the likelihood for positive tests.

Key words
Hypercoagulable states, thrombophilia, central retinal vein occlusion, venous thrombosis, retinal venous occlusive disease


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Especialidades
Principal: Oftalmología
Relacionadas: Hematología, Medicina Interna



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Especialidad principal:
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