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Looking Into the Eyes of Patients with Antiphospholipid Syndrome

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Abstract

Diagnosis of antiphospholipid syndrome (APS) should be considered in all patients with recurrent systemic or ocular thrombosis in the absence of known risk factors. Because of the frequent ocular involvement in APS patients (as many as 80%), an ophthalmologic assessment should become a routine part of the clinical work-up of all patients in whom APS is highly suspected. The presence of isolated ocular thrombosis with persistently increased titers of antiphospholipid antibodies should be considered as definite APS. Ocular involvement in APS is frequently associated with other manifestations of the central nervous system (CNS), such as transient ischemic attack or cerebral vascular events. Diagnostic tools are needed to better establish a diagnosis of retinal vascular thrombosis. The treatment of isolated ocular APS should be based on the same principles as in all patients with systemic APS. Anticoagulation is aimed to prevent recurrent ocular or cerebral thromboses.

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References

  1. Shoenfeld Y (2003) Systemic antiphospholipid syndrome. Lupus 12:497–498

    Article  PubMed  CAS  Google Scholar 

  2. Giorgi D, David V, Afeltra A, Gabrieli CB (2001) Transient visual symptoms in systemic lupus erythematosus and antiphospholipid syndrome. Ocul Immunol Inflamm 9:49–57

    Article  PubMed  CAS  Google Scholar 

  3. Asherson RA, Merry P, Acheson JF, Harris EN, Hughes GR (1989) Antiphospholipid antibodies: a risk factor for occlusive ocular vascular disease in SLE and primary antiphospholipid syndrome. Ann Rheum Dis 48:358–361

    Article  PubMed  CAS  Google Scholar 

  4. Castanon C, Amigo MC, Banales JL, Nava A, Reyes PA (1995) Ocular vaso-occlusive disease in primary antiphospholipid syndrome. Ophthalmology 102:256–262

    PubMed  CAS  Google Scholar 

  5. Carbone J, Sanchez-Ramon S, Cobo-Soriano R, Seoane E, Aparicio MJ, Ruiz-Tiscar JL et al (2001) Antiphospholipid antibodies: a risk factor for occlusive retinal vascular disorders. Comparison with ocular inflammatory diseases. J Rheumatol 28:2437–2441

    PubMed  CAS  Google Scholar 

  6. Durrani OM, Gordon C, Murray PI (2002) Primary anti-phospholipid syndrome: current concepts. Surv Ophthalmol 47:215–238.

    Article  PubMed  Google Scholar 

  7. Giorgi D, Vaccaro F (1997) Vaso-occlusive retinopathy: is it a classical clinical manifestation of the APS. Lupus 6:617

    PubMed  CAS  Google Scholar 

  8. Greven CM, Slusher MM, Weaver RG (1995) Retinal artery occlusion in young adults. Am J Ophthalmol 120:776–783

    PubMed  CAS  Google Scholar 

  9. Demirci FY, Kucukkaya R, Akarcay K, Kir N, Atamer T, Demirci H, Ongor E (1998) Ocular involvement in APS. Int Ophthalmol 22:323–329

    Article  PubMed  CAS  Google Scholar 

  10. Gelfand YA, Dori D, Miller B, Brenner B (1999) Visual disturbances and pathologic ocular findings in primary antiphospholoipid syndrome. Ophthalmology 106:1537–1540

    Article  PubMed  CAS  Google Scholar 

  11. Shoenfeld Y, Lev S, Blatt I, Blank M, Font J, von Landenberg P et al (2004) Features associated with epilepsy in the antiphospholipid syndrome. J Rheumatol 31:1344–1348

    PubMed  Google Scholar 

  12. Cobo-Soriano R, Sanchez-Ramon S, Aparicio MJ, Teijero MA, Vidal P, Suarez-Leoz M et al (1999) Antiphospholipid antibodies and retinal thrombosis in patients without risk factors. Am J Ophthalmol 128:725–732

    Article  PubMed  CAS  Google Scholar 

  13. Kalogeropoulos CD, Spyron P, Stefanioton MI, Tsironi EE, Drosos AA, Psilas KG (1998) Anticardiolipin antibodies and occlusive vascular disease of the eye: prospective study. Doc Ophthalmol 95:109–120

    Article  PubMed  CAS  Google Scholar 

  14. Bashshur ZF, Taher A, Masri AF, Najjar D, Arayssi TK, Noureddin BN (2003) Anticardiolipin antibodies in patients with retinal vein occlusion and no risk factors: a prospective study. Retina 23:486–490

    Article  PubMed  Google Scholar 

  15. Tekeli O, Gursel E, Buyurgan H (1999) Protein C, protein S, and anti-thrombin III deficiencies in retinal vein occlusion. Acta Ophthalmol Scand 77:628–630

    Article  PubMed  CAS  Google Scholar 

  16. Incorvaia C, Bandello F, Parmeggiani F, D’Angelo S, Costagliola C, Sebastiani A (2002) Recurrent central retinal vein occlusion in a young thrombophilic patient with factor V Leiden mutation. Eur J Ophthalmol 12:131–134

    PubMed  CAS  Google Scholar 

  17. Paccalin M, Manic H, Bouche G, Landron C, Mercie M, Boinot C et al (2006) Antiphospholipid syndrome in patients with retinal venous occlusion. Thromb Res 117:365–369

    Article  PubMed  CAS  Google Scholar 

  18. Larsson J, Bauer B, Cavallin-Sjoberg U, Andersson S (1998) Fluorescein angiography vs ERG for predicting the prognosis in central vein occlusion. Acta Ophthalmol Scand 76:456–460

    Article  PubMed  CAS  Google Scholar 

  19. Hvarfner C, Andreasson S, Larsson J (2006) Multifocal electroretinography and fluorescein angiography in retinal vein occlusion. Retina 26:292–296

    Article  PubMed  Google Scholar 

  20. Baxter GM, Williamson TH (1996) The value of serial Doppler imaging in central retinal vein occlusion: correlation with visual recovery. Clin Radiol 51:411–414

    Article  PubMed  CAS  Google Scholar 

  21. Arsene S, Giraudeau B, Le Lez ML, Pisella PJ, Pourcelot L, Tranquart F (2002) Follow-up by colour Doppler imaging of 102 patients with retinal vein occlusion over 1 year. Br J Ophthalmol 86:1243–1247

    Article  PubMed  CAS  Google Scholar 

  22. Giorgi D, Pace F, Giorgi A, Bonomo L, Gabrieli CB (1999) Retinopathy in SLE: pathogenesis and approach to therapy. Hum Immunol 60:688–696

    Article  PubMed  CAS  Google Scholar 

  23. Au A, O’Day J (2004) Review of severe vaso-active retinopathy in systemic lupus erythematosus and the antiphospholipid syndrome: associations, visual outcomes, complications and treatment. Clin Exp Ophthalmol 32:87–100

    Article  Google Scholar 

  24. Kent D, Hickey-Dwyer M, Clark D (2000) Long-term follow-up of ischemic retinopathy in the antiphospholipid syndrome. Eye 14:313–317

    PubMed  Google Scholar 

  25. Mruthyunjaya P, Wirostko WJ, Chandrashekhar R, Stinnet S, Lai JC, Deramo V et al (2006) Central retinal vein occlusion in patients treated with long-term warfarin sodium (coumadin) for anticoagulation. Retina 26:285–291

    Article  PubMed  Google Scholar 

  26. Browning DJ, Fraser CM (2004) Retinal vein occlusions in patients taking warfarin. Ophthalmology 111:1196–1200

    Article  PubMed  Google Scholar 

  27. Finazzi G, Marchioli R, Brancaccio V, Schinco P, Wisloff F, Musial J et al (2005) A randomized clinical trial of high-intensity warfarin vs conventional antithrombotic therapy for the prevention of recurrent thrombosis in patients with antiphosphlipid syndrome. J Thromb Haemost 3:848–853

    Article  PubMed  CAS  Google Scholar 

  28. Glacet-Bernard A, Kuhn D, Vine AK, Oubraham H, Coscas G, Soubrane G (2000) Treatment of recent onset central retinal vein occlusion with intravitreal tissue plasminogen activator: a pilot study. Br J Ophthalmol 84:609–613

    Article  PubMed  CAS  Google Scholar 

  29. Maar N, Luksch A, Graebe A, Ergun E, Wimpissinger B, Tittl M et al (2004) Effect of laser photocoagulation on the retinal vessel diameter in branch and macular vein occlusion. Arch Ophthalmol 122:987–991

    Article  PubMed  Google Scholar 

  30. Cekic O, Chang S, Tseng JJ, Barile GR, Del Priore LV, Weissman H et al (2005) Intravitreal triamcinolone injection for treatment of macular edema secondary to branch retinal vein occlusion. Retina 25:851–855

    Article  PubMed  Google Scholar 

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Acknowledgment

This work was partly supported by The Foundation Federico S.A., for research in Autoimmunity Diseases.

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Authors and Affiliations

  1. Division of Clinical Immunology and Allergy, Bnai-Zion Medical Center, Technion School of Medicine, Haifa, Israel

    D. Yehudai & E. Toubi

  2. Sackler Faculty of Medicine, Department of Internal Medicine B and Center for Autoimmune Diseases, Sheba Medical Center, Tel-Aviv University, Tel Aviv, Israel

    Y. Shoenfeld

Authors
  1. D. Yehudai
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  2. Y. Shoenfeld
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  3. E. Toubi
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Correspondence to E. Toubi.

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Yehudai, D., Shoenfeld, Y. & Toubi, E. Looking Into the Eyes of Patients with Antiphospholipid Syndrome. Clinic Rev Allerg Immunol 32, 192–197 (2007). https://doi.org/10.1007/s12016-007-0002-2

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  • DOI: https://doi.org/10.1007/s12016-007-0002-2

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