Branch Retinal Vein Hemorrhage

[Nancy]

Hi Marty-

I was very happy to see your post. Being stable is good. I hope that at next testing there will be some improvement.

 

[LUVMyBirman]

Marty - he was more or less referring to eye hemorrhage with the Coumadin outside the retinal vein. This is all new to me.

Please keep us updated on your progress. Will be hoping for the best!

 

[Marty]

Update,

Update,

Nancy wanted an update on how my right eye is doing. Not very well. I can see shadows light and dark but no detail. As noted in earlier posts, I have been told the blood should begin to absorb after 3 months and contiue to get better up to 1 year. If some tiype of focal vision has not returned by that time the vision loss is permanent.
I have made some inquiries over the internet to
my med school, IU. the chief of the Low Vision service replied
"I frequently see the end result of patients on blood thinners for various vascular reasons and also experience retinal bleeds. Most frequently the retinal pathology is hemorrhagic macular degenration but branch and central venous and arteriolar bleeds are also seen.Unfortunately as in your case treatment options are few, A decrease in blood viscosity is usually necessary to preserve life, yet exacerbates the vision loss. Close collaboration between your retinologist and cardiovasdcular specialist may result in better titration of your warfarin dosage."
The chief at the VA hospital wrote this " have seen thousands
of patients taking warfarin and there has been no retinal bleeding.You have a higher risk for subconjunctival hemorrhage but this is the only risk."
So you can see as in so many other areas of medicine , there is no agreement on the role of warfarin in retinal bleeding.
What do I believe? I think its like stomach ulcers. Warfarin doesn't start the bleeding but once started can keep it going. I think this is what's happening to me. Another reason to go tissue valve? I think so. Marty

 

[ShezaGirlie]

I agree Marty -- tissue valve all the way!

Coumadin is a dangerous drug... It also makes your hair fall out!
They don't tell you this, do they?

Wonder what else they don't tell us....

Goodluck to you Marty!

 

[catwoman]

Marty:

What is the best medical school in the U.S. -- or the world -- for ophthalmic research? How about a consult with the best expert there? Actually, a little brain-storming would be best...

 

[Sherry]

Hello, Marty,
I wish you the best in getting this taken care of; ironically, I just posted about my own visual disturbances on the other forum. Mine is like a grey curtain being pulled down over my vision. Docs believe it's due to tiny emboli. My INR was low too. I think I may try some folic acid supplements that Al suggested too.

 

[Nancy]

Hi Marty-

I was so hoping to hear a little improvement, but it is still early on from what you have been told.

I'll be keeping you in my thoughts and prayers, that there will be some improvement soon.

 

[Guest]

Marty, weren't we tallking about a possible link between warfarin and macular degeneration when we met three years ago in Washington DC?

I've asked the question of several people with large patient databases such a Kaiser in Denver where there are over 6,000 active participants in their anticoagulation clinic but I haven't heard about anyone doing any research on this. Like you I've found people who say both yes and no.

There has been a study quantifying the relationship between smoking and macular degeneration, so there are some baseline numbers out there. My father took warfarin for about 25 years and he smoked and had macular degeneration.

I realize that your problem is a little different but probably not all that much.

Hope it shows improvement soon.

 

[Marge]

My mother was on coumadin for years because of a history of pulmonary embolism. Later in life she also developed macular degeneration in one eye. Nobody ever mentioned a possible connection with coumadin and this is the first I ever heard of that possibility.

When I say "later in life," I really mean it. She was 96 when she died.

She didn't smoke -- she had smoked in her 20's and 30's but not heavily.

I'm really glad I got that valve repair. A couple more months on warfarin .....

Marty, I can only say I hope things improve for you.

Maybe I should mention that even with macular degeneration, my mom's eyesight outlived her & she was still able to do the things she liked: read, watch television, go to movies and work the x-word puzzles she loved. We were really worried when we got the diagnosis, because, ironically, the MD was in her GOOD eye; she had very poor eyesight in the other one bc of a defective lens implant from a cataract operation.

 

[Raverlaw]

I was diagnosed with the very early stages of MD about a year and one-half ago, well before I knew I would need a new valve. Fortunately for me, I have the "dry" variety of MD, which is primarily age-related and progresses more slowly than "wet" or hemorrhagic MD.

I am concerned about now having to take warfarin, though, particularly as I have not resumed any of my vitamin supplements (Beta-carotene, Vitamin E, Lutein) that I previously took for my eyes while I am waiting to get my INR stabilized.

I plan to see my opthamologist soon and will aske to be monitored more closely due to the warfarin use.

 

[catwoman]

One of my favorite writers, Stephen King, has macular degeneration. Saw something on the bio channel or other network about him and MD was mentioned. Think that's why he's more or less retiring from writing.
Just checked the MD connection and tvtome.com had something updated 3/25/04 about him.

My opthalmologist has cautioned me about retinal detachment because of my severe nearsightedness. Don't know if there's any bleeding incidence with that.

 

[Marty]

A lower INR???

A lower INR???

Yesterday I received a second E-mail from the head of the LowVision service at IU and she said I could read her remarks as recommending that I keep my INR at the lower end of the therapeutic range i.e. 2.5. Since I self regulate I may do this. For five years I have kept my INR between 3.0 and 3.5. At my next visit with the retinologist I will try to find out how he thinks macular degeneration and warfarin may be related. I'm not sure I have MD; last visit he said I have edema and swelling around the macula which is caused by the hemorrhage.