Familial occurrence of elevated levels of antiphospholipid antibodies as well as an association with certain HLA DR4, DR7, DQw7, and DQw53 types were reported. Treatment and monitoring Anticoagulation and immunosuppression seem to be the most effective treatment. Long-term therapy with aspirin, warfarin or heparin was suggested, but duration of the treatment and the point at which it should be discontinued are not clear. The level of INR is recommended to be more than 3. Life-long anticoagulation is necessary in some patients.
Laser photocoagulation is an additional treatment of non-perfused retinal areas.
Treatment can be modulated based on the levels of INR and antiphospholipid antibodies. Patients with IgG anticardiolipin antibodies are at higher risk than those with IgM or IgA antibodies. The probability of thrombosis is higher if both anticardiolipin antibodies and lupus anticoagulant are present simultaneously. Summary Antiphospholipid syndrome is a life threatening and vision threatening multisymptomatic disorder. Laboratory tests are essential for the diagnosis and should be considered in patients with unexplained vascular occlusion.