Anticardiolipin antibodies and occlusive vascular disease of the eye: Prospective study

There is a recognized association between the presence of anticardiolipin a ntibodies and vascular occlusive disease. The purpose of our study is to de tect the presence of high titers of anticardiolipin antibodies (ACA) in the serum and to correlate the titers with the severity of the vascular diseas e in patients with occlusive ocular vascular disease. 82 patients were incl uded in a prospective study; 25 patients with anterior ischaemic optic neur opathy, 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 pati ents. The group of the patients (group A) was compared to an age-matched co ntrol group of 79 healthy individuals (group B). IgG isotype (but not IgM) titers of ACA were found significantly higher in group A (P < 0.001). In pa tients with titers of ACA (IgG isotype) > 100 units we noted a higher incid ence of a more severe disease (recurrency, involvement of both eyes or extr aocular manifestations) especially among those with anterior ischaemic opti c neuropathy and secondarily in those with retinal artery occlusion. Our results suggest that the association between high titers of ACA and occ lusive vascular disease of the eye concerns only the IgG isotype. In additi on, the detection of high titers of IgG/AGA in patients could be a useful m arker for disease severity and prognosis and this observation seems to be m ore explicit in cases with arterial occlusive disease than in cases with ve nous occlusive disease.