Central retinal vein occlusion in patients treated with long-term warfarin sodium (Coumadin) for anticoagulation.
OBJECTIVE
To describe the clinical features of persons who developed central retinal vein occlusion (CVO) while being treated with Coumadin for chronic anticoagulation.


METHODS
In a retrospective, comparative, noninterventional case series of patients diagnosed with CVO while being treated with Coumadin as a systemic anticoagulant, visual and anatomical outcomes were compared with those for a cohort of patients diagnosed with CVO who were not treated with any systemic anticoagulation.


RESULTS
Fourteen eyes of 14 patients treated with Coumadin were identified. At presentation, the median international normalization ratio (INR) was 2.20 (range, 1.3-5.0). Eight patients (57%) had a therapeutic INR at the time of CVO. Their visual acuity and perfusion status were similar to those of patients with subtherapeutic INR. At the last follow-up (median, 16 months), visual acuity and perfusion status of the group of 14 eyes were similar to baseline findings (P = 0.62). Clinical features and outcomes were similar to those for a cohort of patients with CVO who were not being treated with systemic anticoagulation.


CONCLUSIONS
CVO can occur in patients being treated with Coumadin for systemic anticoagulation. Final visual acuity and perfusion status were similar to those in a cohort of patients with CVO who were not treated with Coumadin. Although visual acuity is unaffected, ensuring that the INR for these patients remains in the therapeutic range may be important to help prevent secondary systemic thrombotic and embolic disease.
Mruthyunjaya
Prithvi
P
Duke University Eye Center, Durham, North Carolina 27710, USA.
Wirostko
William J
WJ
Chandrashekhar
Ravindra
R
Stinnett
Sandra
S
Lai
James C
JC
Deramo
Vincent
V
Tang
Johnny
J
Dev
Sundeep
S
Postel
Eric A
EA
Connor
Thomas B
TB
Fekrat
Sharon
S
D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects*; D001777:Blood Coagulation / Q000187:drug effects; D005123:Eye / Q000098:blood supply; D005260:Female; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D008875:Middle Aged; D012170:Retinal Vein Occlusion / Q000139:chemically induced*; D012171:Retinal Vessels / Q000502:physiology; D012189:Retrospective Studies; D013927:Thrombosis / Q000188:drug therapy*; D014792:Visual Acuity; D014859:Warfarin / Q000009:adverse effects*
D000925:Anticoagulants; D014859:Warfarin