Antiphospholipid antibodies: A risk factor for occlusive retinal vascular disorders. Comparison with ocular inflammatory diseases

Objective. To evaluate the prevalence of antiphospholipid antibodies (aPL) together with immunological characteristics of patients with occlusive reti nal vascular disorders (ORVD) with and without risk factors (systemic arter ial hypertension, diabetes mellitus, hyperlipidemia. and embolizing cardiac disease) for retinal occlusions compared to patients with ocular inflammat ory diseases (OID) and healthy controls. Methods. Sixty-eight patients with ORVD, 45 patients with OID, and 49 healt hy persons were prospectively studied. Serologic studies included determina tion of anticardiolipin antibodies, lupus anticoagulant, antinuclear antibo dies (ANA), levels of complement 4 and 3, total hemolytic complement (CH100 ), and circulating immune complexes (CIC). Results. Elevated levels of aPL were detected in 16 (24%) patients with ORV D compared to 4 (9%) patients with OID (OR 3.15, p < 0.05) and 4 (8%) contr ols (OR 3.46, p < 0.05). No significant differences were seen in the preval ence of aPL comparing risk factor-positive patients with ORVD (8 of 33, 24% ) to risk factor-free patients with ORVD (8 of 35, 23%). A higher frequency of positive ANA, elevated IgA, and increased CIC were detected in aPL posi tive patients with ORVD compared to patients with OID. Conclusion. Detection of aPL in patients with ORVD may help determine which patients are eligible for prophylactic treatment. An immunologic profile c haracterized by high prevalence of ANA, CIC, and elevated IgA distinguishes ORVD patients with aPL from inflammatory ophthalmologic disorders.