Anticardiolipin antibodies and occlusive vascular disease of the eye: Prospective study Authors
Cite this article as: Kalogeropoulos, C.D., Spyrou, P., Stefaniotou, M.I. et al. Doc Ophthalmol (1998) 95: 109. doi:10.1023/A:1001131323739 Abstract
There is a recognized association between the presence of anticardiolipin antibodies and vascular occlusive disease. The purpose of our study is to detect the presence of high titers of anticardiolipin antibodies (ACA) in the serum and to correlate the titers with the severity of the vascular disease in patients with occlusive ocular vascular disease. 82 patients were included in a prospective study; 25 patients with anterior ischaemic optic neuropathy, 36 with retinal vein occlusion and 21 with retinal artery occlusion. ACA (IgG and IgM isotypes) were measured by ELISA in the sera of all patients. The group of the patients (group A) was compared to an age-matched control group of 79 healthy individuals (group B). IgG isotype (but not IgM) titers of ACA were found significantly higher in group A (P < 0; 0.001). In patients with titers of ACA (IgG isotype) > 100 units we noted a higher incidence of a more severe disease (recurrency, involvement of both eyes or extraocular manifestations) especially among those with anterior ischaemic optic neuropathy and secondarily in those with retinal artery occlusion.
Our results suggest that the association between high titers of ACA and occlusive vascular disease of the eye concerns only the IgG isotype. In addition, the detection of high titers of IgG/AGA in patients could be a useful marker for disease severity and prognosis and this observation seems to be more explicit in cases with arterial occlusive disease than in cases with venous occlusive disease.
anticardiolipin antibodies eye occulusive vasculopathy vasculitis
This revised version was published online in July 2006 with corrections to the Cover Date.
Alarcón-Segovia D. The pathophysiology of antiphospholipid antibodies. Semin Clin Immunol 1991; 1: 11–19.
Harris EN, Gharavi AE, Boey ML et al. Anticardiolipin antibodies: detection by radioimmunoassay and association with thrombosis in SLE. Lancet 1983; ii: 1211–4.
Harris EN, Gharavi AE, Asherson RA, Boey ML, Hughes GRV. Cerebral infarction in systemic lupus: association with anticardiolipin antibodies. Clin Exp Rheum 1984; 2: 47–51.
Alarcón-Segovia D, Cardiel MH, Reyes E. Antiphospholipid arterial vasculopathy. J Rheumatol 1989; 16: 762–7.
McHugh NJ, Maymo J, Skinner RP et al. Anticardiolipin antibodies, livedo reticularis and major cerebrovascular and renal disease in systemic lupus erythematosus. Ann Rheum Dis 1988; 47: 110–5.
Gharavi AE, Harris EN, Asherson RA, Hughes GRV. Anticardiolipin antibodies: isotype distribution and phospholipid specificity. Ann Rheum Dis 1987; 46: 1–6.
Hamsten A, Norberg R, Bjorkholm M et al. Antibodies to cardiolipin in young survivors of myocardial infarction: an association with resurrent cardiovascular events. Lancet 1986; i: 13–16.
Levine SR, Deegan MJ, Futrell N, Welch KMA. Cerebrovascular and neurologic disease associated with antiphospholipid antibodies: 48 cases. Neurology 1990; 40: 1181–9.
Triplett DA. Antiphospholipid antibodies and thrombosis. A consequence, coincidence, or cause? Arch Pathol Lab Med 1993; 117: 78.
Asherson RA, Merry P, Acheson JF et al. Antiphospholipid antibodies: a risk factor for occlusive ocular vascular disease in systemic lupus erythematosus and the 'primary' antiphospholipid syndrome. Ann Rheum Dis 1989; 48: 358–61.
Snyers B, Lambert M, Hardy JP. Retinal and choroidal vaso-occlusive disease in systemic lupus erythematosus associated with antiphospholipid antibodies. Retina 1990; 10: 255–60.
Hughes GRV, Khamashta MA. Anticardiolipin antibody. A cause of a tendency to thrombosis. Br Med J 1989; 299: 1414–5.
Watts MT, Greaves M, Rennie IG, Clearkin LG. Antiphospholipid antibodies in the aetiology of ischaemic optic neuropathy. Eye 1991; 5: 75–9.
Glacet-Bernard A, Bayani N, Chretien P et al. Antiphospholipid antibodies in retinal vascular occlusions; a prospective study of 75 patients. Arch Ophthalmol 1994; 112: 790–5.
Pivetti-Pezzi P, Priori R, Catarinelli G et al. Markers of vascular injury in Behcet's disease associated with retinal vasculitis. Ann Ophthalmol 1992; 24: 411–4.
Hartnett ME, Pruett RC, DaSilva KC, Burkart PT. Antiphospholipid antibody syndrome associated with microscotomata. Am J Ophthalmol 1994; 118: 397–8.
Acheson JF, Gregson RMC, Merry P, Schulenburg WE. Vaso-occlusive retinopathy in the primary antiphospholipid antibody syndrome. Eye 1991; 5: 48–55.
Pulido JS, Ward LM, Fishman GA et al. Antiphospholipid antibodies associated with retinal vascular disease. Retina 1987; 7: 215–8.
Manoussakis MN, Gharavi AE, Drosos AA et al. Anticardiolopin antibodies in unselected autoimmune rheumatic disease patients. Clin Immunol and Immunopathol 1987; 44: 297–307.
Winterkorn JMS, Kupersmith MJ, Wirtschafter JD, Forman S.Brief report: treatment of vasospastic amaurosis fugax with calcium-channel blockers. N EngI J Med 1993; 329: 396–8.
Bertram B, Haase G, Remky A, Reim M. Anti-Cardiolipin-Antikörper bei Gefäßverschlüssen am Auge. Ophthalmologe 1994; 91: 768–771.
Merry P, Acheson JF, Asherson RA et al. Management of retinal vein occlusion. Br Med J 1988; 296: 294.
Johnson MW, Thomley ML, Huang SS, Gass JDM. Idiopathic recurrent branch retinal arterial occlusion; natural history and laboratory evaluation. Ophthalmology 1994; 101: 480–9.
Miret C, Cervera R, Reverter JC et al. Antiphospholipid syndrome without an-tiphospholipid antibodies at the time of the thrombotic event. Transiet 'seronegative' antiphospholipid syndrome? Clin Exp Rheum 1997; 15: 541–544
Cronin ME, Biswass RM, Van der Straeton C et al. IgG and IgM anticardiolipin antibody associated clinical syndrome. J Rheum 1988; 15: 795–8.
McNeil HP, Chesterman CN, Krilis SA. Anticardiolipn antibodies and lupus antico-agulants comprise separate antibody subgroups with different phospholipid binding characteristics. Br J Hematol 1989; 73: 506–13.
Palmer HE, Jurd KM, Hunt BJ et al. Thrombophilic factors in ischaemic and non-ischaemic idiopathic retinal vasculitis. Eye 1995; 9: 507–12.
Galeta SL, Plock GL, Kushner MJ et al. Ocular thrombosis associated with antiphospholipid antibodies. Ann Ophthalmol 1991; 23: 207–12.
Canoso RT, Lewis ME, Yunis EJ. Association of HLA-Bw44 with chlorpromazine-induced autoantibodies. Clin Immunol Immunopathol 1982; 25: 278–82.
Manoussakis MN, Tzioufas AG, Silis MP et al. High prevalence of anti-cardiolipin and other autoantibodies in a healthy elderly population. Clin Exp Immunol 1987; 69: 557–65.
PubMed Copyright information
© Kluwer Academic Publishers 1998