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Retinal Vascular Occlusive Disorders and Inflammatory Biomarkers of Metabolic Syndrome

Sonja Cekic, Ivan Jovanović, Gordana Stanković Babić, Predrag Jovanovi?, Vesna Jakšić, Milka Mavija and Dane Krtinic

Background: Retinal vascular occlusion disorders: vein occlusion, central and branch, central arterial occlusion, or branch arterial occlusion as well as anterior ischemic (non arteritic) papillopathy are not rare. They are followed by abrupt decrease of vision acuity, and are complication of different systemic metabolic disorders.
Aim: The aim of this study is to explain possible relationship between inflammatory biomarkers of metabolic syndrome and appearance of retinal vascular net occlusion.
Patients and methods: Prospective case control study was carried on 90 individuals with central retinal vein occlusion, 20 with central arterial retinal occlusion, and 30 with anterior ischemic papillopathy.
The standard ophthalmic examination was obtain, photophundus and fluorescein angiography. Hematological parameters (ESR, WBC, and RBC) and biochemical analysis were done (levels of uric acid, creatinin and urea, plasma fibrinogen level, C reactive protein, glycemia, glycated hemoglobin A1C, total cholesterol, and its fractions, triglycerides). We used National Cholesterol Education Program criteria for metabolic syndrome.
Results: Among examined patients 62(69%) were with CRVO, and 28(31%) with BRVO. Fifty four (60%) patients with vein occlusion meet all criteria for metabolic syndrome. The mean level of glycemia was 8,9 mmol /L, CRP 21mmol/L, total cholesterol 6,7mmol/L, LDL 4,2 mmol/L, triglycerides 1,7 mmol/L and ESR 18 mm/h. Among patients with diagnose of CRAO 12 (60%) and 24 (80%) patients with AION meet the criteria for metabolic syndrome. The mean level of ESR in patients with CRAO was 24/h, glycemia 7,2 mmol /L, CRP 34 mmol/L, cholesterol 7,2 mmol/L, LDL 5,2 mmol/L, and triglycerides 2,7 mmol/L. In patients with AION, the average value of ESR was 20/h, glycaemia 6,9 mmol /L, CRP 54 mmol/L, total cholesterol 8,2 mmol/L, LDL 5,4 mmol/L, and triglycerides 3,0 mmol/L.
Conclusion: Retinal vascular occlusions are not so rare in metabolic syndrome. The CRP is an important parameter in following these conditions, as well as lipid levels, ESR and glycemia and HDL.