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Warfarin Institute of America Dedicated To Your Health |
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RETINAL VEIN OCCLUSIONS (BLOOD CLOTS IN THE EYE) |
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PLEASE NOTE THAT THIS IS NOT PINK EYE, NOR REDNESS IN THE WHITE PART OF YOUR EYE. Browning and Fraser reported on a group of thirteen patients who developed retinal vein occlusions (RVO) in spite of the fact that they were taking warfarin. Seven(53.8%) were female. All were white. They ranged in age from 44 to 86 years. The reasons for taking warfarin were as follows: Stroke – 4; Ischemic Heart Disease – 3; Deep Vein Thrombosis – 2; Aortic Valve Replacement – 2; Lupus Anticoagulant – 1; Atrial fibrillation -1. The INR at the time the RVO occurred ranged from 0.9 to 3.8 with 9 (69.2%) having INRs less than 2.0. (One person had an INR of 0.9 so it is unlikely that the warfarin was being taken even though it had been prescribed.) Three (23.1%) were also taking aspirin in addition to the warfarin. The visual acuity at the longest follow-up date varied from seeing hand motion only (1 person) to counting fingers only (1 person) to 20/16 (1 person). The ten others all had visual acuity between these extremes. I have seen one patient with this condition. She was 32 years old at the time of the RVO. She has at least a 22-year history of clotting events associated with systemic lupus. At age 31 her renal function rapidly deteriorated to the point of requiring kidney dialysis. Her INRs around the time of the RVO were: Feb – 2.6; Mar – 2.9; Apr – 3.8; May 17 – 5.2; May 24 – 2.8; DURING THIS PERIOD THE RVO DEVELOPED; Jun 9 – 2.3; Jun 21 – 2.8; Jul 2.1. Three months after the RVO she can only distinguish "maybe" light from dark in that eye. She remains a competitive pool player despite her loss of vision in one eye. Kent et al. reported on two cases of ischemic retinopathy that revascularized after anticoagulation to keep the INR above 3.0. (These may not have been RVOs – I only had access to the abstract of the article and it did not specify the site.) This may not have been an option in the patient that I saw since three times in the period around the time of the RVO she reported excessive bruising or excessive bleeding from her dialysis site that took about one hour to stop. Fortunately this is a fairly rare complication for people taking warfarin. A few have made good recoveries but for many it results in serious disability. References: Browning DJ, Fraser CM. Retinal vein occlusions in patients taking warfarin. Ophthalmology 2004;111:1196-1200. Kent D et al. Long-term follow-up of ischaemic retinopathy in the antiphospholipid syndrome with lupus-like disease. Eye 2000;14;313-7 SEE A CATALOG OF PUBLICATIONS AVAILABLE FROM LODWICK CREATIONS, LLC. LEARN HOW YOU CAN BECOME LISTED ON THE HONOR ROLL OF SUPPORTERS AND TAKE ADVANTAGE OF THE BENEFITS REQUEST A MEDICATION CONSULTATION CHECK OUR LINE OF "HAD YOUR RAT POISON TODAY?" MERCHANDISE
© 2004 Lodwick Creations, LLC Home Back to interactions list Contact Mr. Lodwick at allodwick@earthlink.net Last updated September 4, 2004
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