Resistance to activated protein C in a young patient with central retinal vein occlusion

Abstract

Central retinal vein occlusion (CRVO) is one of the commonest vascular diseases of the eye, usually observed in old people. Its pathogenesis is multifactor, implicating local factors (glaucoma) and systemic ones (arterial hypertension, diabetes, arteriosclerosis, dyslipemia,…). Moreover, acquired and/or inherited thrombophilic states (hyperhomocysteinemia, antiphospholipide antibodies, activated protein C resistance (APCR), protein C , S and antithrombin deficiencies…) are risk factors predisposing to the disease, particularly in young subjects. In this paper, We report the case of a 43-year-old patient hospitalized in Charles Nicolle hospital for CRVO complicated with neo-vascular glaucoma and blindness of the right eye. The search for risk factors in our patient revealed the presence of hypertriglycideremia associated with a thrombophilic marker : the APCR. The factor V Leiden was not searched for. In literature, APCR seems to be for some authors, a thrombophilic risk predisposing to CRVO. So, it is likely necessary to evaluate in front of a CRVO, beside the systemic risk factors, the thrombophilic markers particularly in young people.