Retinal and orbital venous occlusions treated with enoxaparin.
BACKGROUND
Retinal and orbital vein occlusions may cause a decrease in visual acuity. There is no known therapy to resolve ocular thrombosis. The authors used enoxaparin, a low-molecular-weight heparin, to treat 8 consecutive cases of retinal vein occlusions in 7 patients and 1 case of a superior orbital vein occlusion.


METHODS
Four (4) central retinal vein occlusions in 3 patients, 4 branch retinal vein occlusions in 4 patients, and 1 superior orbital vein occlusion in 1 patient were treated with subcutaneous (SC) enoxaparin 100 IU/kg twice a day. The treatment lasted from 2 to 19 weeks. Eight (8) patients with retinal vein occlusions treated with ticlopidine were used as controls.


RESULTS
The 8 retinal vein occlusions opened up in all 7 patients with the absorption of the retinal edema and hemorrhage as soon as the occlusions were open. The orbital vein occlusion resolved with the absorption of the orbital edema. Visual acuity improved in 7 of the venous occlusions and was unchanged in 2. Visual acuity in the 8 controls improved in 4, was unchanged in 2, and was worse in 2.


CONCLUSIONS
Enoxaparin can be given SC twice a day in patients with retinal or orbital vein occlusions. The occlusions may take from 2 to 19 weeks to open up. Once the vein occlusions are open, the retinal edema, hemorrhage, and the orbital edema can rapidly absorb with visual improvement.
Steigerwalt
Robert D
RD
Private practice, Rome, Italy. r.steigerwalt@libero.it
Cesarone
M Rosaria
MR
Belcaro
Gianni
G
Quercioli
Pierpaolo
P
Lofoco
Giorgio
G
Ciucci
Francesco
F
Pascarella
Antonella
A
Angelis
Mauro De
MD
Rapagnetta
Laura
L
Nebbioso
Marcella
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004334:Drug Administration Schedule; D017984:Enoxaparin / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D009915:Orbit / Q000098:blood supply* / Q000187:drug effects* / Q000473:pathology; D012170:Retinal Vein Occlusion / Q000188:drug therapy* / Q000473:pathology
D017984:Enoxaparin