Is elevated level of soluble endothelial protein C receptor a new risk factor for retinal vein occlusion?


  • The study was presented in part at Association for Research in Vision and Ophthalmology annual meeting, Ft Lauderdale, Florida, USA, 4 May 2005.

Dr Sibel Kadayifcilar, Hacettepe University, School of Medicine, Department of Ophthalmology, TR-06100 Sihhiye, Ankara, Turkey. Email:


Background:  To evaluate the systemic and thrombophilic risk factors for retinal vein occlusion (RVO) and to determine whether the elevated level of soluble endothelial protein C receptor (sEPCR) is a risk factor for thrombosis.

Methods:  In this case–control study, 56 patients with central RVO (CRVO), 26 patients with branch RVO (BRVO) and 78 healthy sex- and age-matched subjects were enrolled. Following ophthalmological examination, venous blood was analysed for glucose, lipid profile, lipoprotein (a), homocysteine, activated partial thromboplastin time, fibrinogen, factor VIII, protein C activity, protein S activity, activated protein C resistance, antithrombin III activity, lupus anticoagulant, anti-cardiolipin antibody, anti-phospholipid antibody, sEPCR, factor V Leiden mutation and prothrombin G20210A mutation.

Results:  Apart from hypertension, glaucoma, lipoprotein (a), homocysteine and factor VIII, elevated levels of sEPCR were found to be a risk factor for CRVO (odds ratio, 1.02; 95% confidence interval, 1.007–1.028; P = 0.001). Patients with CRVO had significantly higher levels of sEPCR than those with BRVO and controls (respectively, 160.1 ± 83.8, 116.8 ± 65.2 and 111.3 ± 60.5; P = 0.005). Moreover, 39% of patients with CRVO had levels of sEPCR more than 200 ng/mL, and only 5% of controls and 11% of patients with BRVO had similar high levels.

Conclusions:  Besides known classical risk factors, elevated levels of sEPCR seem to be an important candidate risk factor for especially CRVO.