.

 Section 9 Tables
Table 1: Predominant associations for vein occlusions
Patient group Hypertension  Hyperlipidaemia Diabetes Mellitus  No obvious cause
Young patients less
than 50 years old
25%
35%
3%
40%
Older patients over
50 years
64%
34%
4-15%
21%
Asian (from Indian subcontinent)
64%
50%
29%
10.7%
West Indian 
83%
33%
38%
8.3%
Recurrent cases
88%
47%
3%
6%
Odd ratio 
1.8 - 2.5
  
 1.6 - 2.1
   
m
m
Table 2: Initial Medical Investigations for Patients Presenting with Retinal Vein Occlusion
ALL PATIENTS
  • Full blood count and ESR or plasma viscosity
  • Urea, electrolytes, creatinine
  • Random blood glucose
  • Random cholesterol and HDL cholesterol+
  • Plasma protein electrophoresis
  • ECG+
  • Thyroid function

    • + It is essential to record these investigations for the Framingham equation
MORE SPECIALISED TESTS ACCORDING TO CLINICAL INDICATION
  • Thrombophilia screen
  • Anti-cardiolipin antibody, lupus anticoagulant
  • C-reactive protein
  • Serum ACE
  • Auto-antibodies - rheumatoid factor / anti-nuclear / anti DNA / ANCA
  • Chest X-ray
  • Fasting homocystine level
 
m
m
Table 3: Guide to diagnosis and targets for cardiovascular risk factors
Blood pressure 
(mm/Hg)		 Diagnosis of hypertension > 140/ and, or > 90 sustained

Optimal blood pressure is < 140/85

Audit standard is < 150/<90
Cholesterol 
(mmol/l)		 Primary prevention - (CHD risk > 15% or total CVD risk > 20% 10 year risk)* +, statin usually required.

Secondary prevention target is <4.8 mmol/l, use of statin required
Diabetes mellitus Diagnosis = fasting glucose > 7.0 mmol/l (multiple sampling)

Glycosylated haemoglobin target is < 7%

Optimal blood pressure is <130/80

Audit standard is <140/<80
Aspirin Indicated if CHD risk > 15% 10 year* and (or CVD risk > 20%)+,in hypertensive patients, providing satisfactory blood pressure control and no contra- indication (peptic ulcer, allergy, history of haemorrhage e.g. recent haemorrhagic stroke, or in the initial stages of a severe haemorrhagic retinal vein occlusion)
* Coronary Heart Disease (CHD) and Total CardiovascularDisease (CVD) risk
calculated using the Framingham Equation, either using chart, discs or
computerised programs (See Joint British Guidelines and British Hypertension
Society guidelines).44,45,48,49
Variables required for the calculation include random cholesterol, HDL cholesterol,systolic blood pressure levels, and age, sex, the presence of diabetes mellitus,smoking, and the presence of left ventricular hypertrophy on ECG.
+ British Hypertension Society guidelines 200449
Introduction Methods used Risk factors CRVO
BRVO Medical treatment Cardiovascular problems Young patient
References. Tables Main index Main page.
.............