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Klin Monbl Augenheilkd 2004; 221(5): 357-359
DOI: 10.1055/s-2004-812813
Originalarbeit

© Georg Thieme Verlag KG Stuttgart · New York

Increased Endothelin-1 Plasma Level in Young Adults with Retinal Vascular Occlusive Diseases

Erhöhter Endothelin-1-Plasmaspiegel bei retinalen Gefäßverschlüssen jüngerer PatientenT. Haufschild1 , C. Prünte1 , J. Messerli1 , J. Flammer1
  • 1University Eye Clinic, Basel, Switzerland (Head: J. Flammer, MD)
Further Information

Publication History

received: 19.9.2003

accepted: 5.11.2003

Publication Date:
26 May 2004 (online)

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Zusammenfassung

Hintergrund: Retinale Gefäßverschlüsse werden relativ häufig bei älteren Patienten gesehen. Gelegentlich kommen sie aber auch bei jüngeren Patienten ohne Arteriosklerose vor. Wir vermuten in diesen Fällen eine zugrunde liegende vaskuläre Dysregulation. Patienten und Methoden: In einer prospektiven Studie analysierten wir sechs Patienten unter 55 Jahren: drei Männer mit venösen retinalen Verschlüssen und drei Frauen mit arteriellen retinalen Verschlüssen. Wir suchten nach Zeichen einer vaskulären Dysregulation und bestimmten den Endothelin-1-(ET-1-) Plasmaspiegel. Ergebnisse: Bei allen untersuchten Patienten war der ET-1-Plasmaspiegel deutlich erhöht. Der Mittelwert lag mit 3,72 ± 0,8 pg/ml signifikant (p < 0,001) über dem in dieser Altersgruppe zu erwartenden Wert (1,52 ± 0,24 pg/ml). Alle Fälle zeigten in der Kapillarmikroskopie eine vaskuläre Dysregulation. In der Anamnese wurden von allen Patienten gehäuft kalte Extremitäten und von vier Patienten eine Migräne angegeben. Hingegen wurden weder Veränderungen der Gefäße im Carotis- und Ophthalmica-Gebiet noch Störungen der Hämostase und Fibrinolyse gefunden. Schlussfolgerungen: Alle sechs untersuchten Patienten unter 55 Jahren mit retinalen Gefäßverschlüssen hatten eine vaskuläre Dysregulation und erhöhte ET-1-Plasmaspiegel. Ein Zusammenhang zwischen der vaskulären Dysregulation und den Gefäßverschlüssen ist deshalb wahrscheinlich.

Abstract

Background: Vascular occlusive diseases are usually seen in the elderly but can occur even in younger patients without arteriosclerosis. We assume a vascular dysregulation as a underlying pathogenetic mechanism. Patients and methods: In a prospective study we analysed the clinical findings of six patients under 55 years of age, three men with retinal vein occlusions and three women with branch retinal arterial obstructions. They were examined for signs of a vascular dysregulation and the endothelin-1 (ET-1) plasma level was measured. Results: In all patients the ET-1 plasma level was markedly elevated. The mean value (3.72 ± 0.8 pg/ml) was significantly increased compared to normal values for that age (1.52 ± 0.24 pg/ml; p < 0.001). In all cases an increased tendency for vascular dysregulation could be demonstrated in nailfold capillaroscopy. Furthermore, frequent coldness of the extremities was mentioned by every patient and migraine was mentioned by four patients whereas neither changes of the vessels in carotis and ophthalmica region nor disturbances in the haemostasis and fibrinolysis could be found. Conclusions: All six patients with vascular occlusive diseases occurring before the age of 55 had a vascular dysregulation and increased ET-1 plasma levels. A relationship between the vascular dysregulation and the vascular occlusive diseases is therefore likely.

Schlüsselwörter

Endothelin-1 - retinale Gefäßverschlüsse - vaskuläre Dysregulation

Key words

Endothelin-1 - retinal vascular occlusive diseases - vascular dysregulation

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J. Flammer, M.D.

University Eye Clinic

Mittlere Strasse 91

P.O. Box

4012 Basel


Switzerland

Phone: +41-61-2 65-87 87

Fax: +41-61-2 65-86 52

Email: Josef.Flammer@uhbs.ch

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