Retinal vein occlusions in patients taking warfarin.
OBJECTIVE
To describe development of retinal vein occlusion (RVO) in patients anticoagulated with warfarin.


METHODS
Retrospective, observational case series.


METHODS
Thirteen patients drawn from a private retina practice.


METHODS
Review of clinical records, laboratory results, color fundus photographs, and fluorescein angiograms.


METHODS
Primary measures were international normalized ratio (INR), visual acuity, and concurrent systemic disease.


RESULTS
The female-to-male ratio was 7 to 6. Age range was 44 to 86 years, with a median age of 73 years. Two patients had systemic lupus erythematosus, 7 had hypertension, and 2 had primary open-angle glaucoma. Two had laboratory abnormalities: 1 with a combination of lupus anticoagulant and anticardiolipin antibodies and 1 with a combination of hyperhomocystinemia and low antithrombin III. Three patients were taking acetylsalicylic acid in addition to warfarin at the time of the RVO. The INRs at the time of RVO were 0.9 to 3.8, with 9 of 13 <==2.0.


CONCLUSIONS
Anticoagulation with warfarin does not preclude RVO in predisposed patients, nor does combination therapy with warfarin and acetylsalicylic acid. Attention to keeping the INR >2.0 may be helpful.
Browning
David J
DJ
Charlotte Eye, Ear, Nose, and Throat Associates, Charlotte, North Carolina, USA. dbrowning@ceenta.com
Fraser
Christina M
CM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects*; D001241:Aspirin / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012169:Retinal Vein / Q000187:drug effects*; D012170:Retinal Vein Occlusion / Q000139:chemically induced*; D012189:Retrospective Studies; D014859:Warfarin / Q000009:adverse effects*
D000925:Anticoagulants; D014859:Warfarin; D001241:Aspirin