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Hypercoagulability Testing and Hypercoagulable Disorders in Young Central Retinal Vein Occlusion Patients

  • Zujaja Tauqeer
    Affiliations
    Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
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  • Peter Bracha
    Affiliations
    Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania

    Gundersen Eye Institute, Gundersen Health System, La Crosse, Wisconsin
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  • Brendan McGeehan
    Affiliations
    Center for Preventative Ophthalmology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
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  • Brian L. VanderBeek
    Correspondence
    Correspondence: Brian L. VanderBeek, MD, MPH, Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania Perelman School of Medicine, 51 North 39th Street, Philadelphia, PA 19104.
    Affiliations
    Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania

    Center for Pharmacoepidemiology Research and Training, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania

    Leonard Davis Institute, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
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Published:March 24, 2021DOI:https://doi.org/10.1016/j.oret.2021.03.009

      Purpose

      To determine frequency of hypercoagulability testing and hypercoagulable states in patients with central retinal vein occlusion (CRVO) younger than 50 years.

      Design

      Retrospective cohort study.

      Participants

      Deidentified patients younger than 50 years with newly diagnosed CRVO from a national insurance claims database.

      Methods

      The de-identified Clinformatics Data Mart Database (Optum) containing medical claims from a commercial and Medicare Advantage insurance database was used. All outpatient medical claims (office visits, associated diagnoses, and laboratory testing) and demographic data for each beneficiary during their enrollment were accessible.

      Main Outcome Measures

      Prevalence of (1) laboratory hypercoagulable workup within 90 days of CRVO diagnosis, (2) new diagnosis of a hypercoagulable state within 1 year of CRVO diagnosis, and (3) diagnosis of hypertension, diabetes mellitus (DM), and hyperlipidemia.

      Results

      One thousand one hundred eighty-one patients met inclusion criteria. Six hundred seventy-one patients (56.8%) were men, 450 patients (38.1%) had undergone hypercoagulable testing within 90 days, and 136 patients (11.5%) were diagnosed with a hypercoagulable state within 1 year after CRVO diagnosis. This proportion was similar between those patients with DM, hypertension, or hyperlipidemia (10.5% [65/620]) and those without (12.7% [71/561]; P = 0.28). Of the 136 patients diagnosed with a hypercoagulability state, 68.4% (93/136) had undergone testing within 90 days of CRVO diagnosis and 31.6% (43/136) did not. Of those who had not undergone hypercoagulability testing, 5.9% (43/731) were diagnosed with a hypercoagulable state within 1 year compared with 20.7% (93/450) in those who were tested (P < 0.001).

      Conclusions

      The prevalence of a hypercoagulable state within 1 year of CRVO diagnosis in patients younger than 50 years was 11.5%, and the prevalence was similar between patients with atherosclerotic risk factors and those without. Rate of testing was only 38.1%. Future research should examine the usefulness of uniform hypercoagulable testing in young CRVO patients.

      Keywords

      Abbreviations and Acronyms:

      CRVO (central retinal vein occlusion), DM (diabetes mellitus), ICD (International Classification of Diseases), RVO (retinal vein occlusion)
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