Update on BRVT

[Marty]

I posted about six months ago about losing the sight in my right eye due to a branch retinal vein thrombosis. This results in blood backing up and oozing out all over the macula and retina. I can see a little light and thats about it. Yesterday I had a gloomy visit with the retinologist who said there is still way too much blood to do laser or anything else. He hopes I don't get glaucoma from it because then the eye might have to come out. But he made one very interesting comment. He said he can't understand why he sees so many patients who get this while on Coumadin. You would think Coumadin would make thrombosis unlikely.I checked with authorities around the country including clotting guru Jack Ansell in Boston. They all say coumadin should cut down on thrombosis but once bleeding starts it will keep it going. The eye doctor wishes there was some way to stop the Coumadin but knows there is no way to do it. One eye specialist from IU said maybe I should keep my INR closer to 2.5 rather than between 3.0 and 3.5 where I tend to stay.

 

[Ross]

That's interesting. I don't see how they figure there might be a difference if your INR is lower. Seems to me that if it's going to bleed, INR isn't going to make much of difference.

 

[Marty]

That's interesting. I don't see how they figure there might be a difference if your INR is lower. Seems to me that if it's going to bleed, INR isn't going to make much of difference.

Ross,I think the idea is based on the fact that we tend to bleed more as the INR goes up to 5+ and beyond and clot as it heads down toward 1. I've already got a thrombus in the branch retinal vein so I agree i don't see how further clotting woudl stop the oozing from blood behind the clot.Anyhow I'm still keeping my INR in the high therapeutic range because I don't wan't a clot on the valve.

 

[Mary]

Can somebody explain this to me?

Can somebody explain this to me?

Almost ten years ago my mother had a series of small strokes. The MRI showed small blood vessels in the brain stem slowly leaking/bleeding. She was put on coumadin, because obviously anything going wrong in the brain stem is bad.

I never really considered why she was on the coumadin, but I suppose I thought it was to make the blood clot. Now I'm thinking that makes no sense. Does anyone know the answer? I hate to drag it back up with her.
Mary

 

[Nancy]

Marty-

I just wanted to tell you that I am so sorry that this problem is progressing. I was so hoping that it would eventually resolve.

You will be in my thoughts and prayers.

 

[Ross]

Marty I didn't mean to dismiss the seriousness of it. I too hope that it will reverse.

 

[bvdr]

Hi Marty, I'm sorry you are still having problems. Was the thrombus valve related? I'm just thinking that basically all patients are put on coumadin because they are in such a high risk group. If the eye specialists note a substantial amount of coumadin patients with BRVT then maybe it is micro-emboli from a valve?

Regardless, I hope it soon clears up for you.

 

[Marty]

Hi Marty, I'm sorry you are still having problems. Was the thrombus valve related? I'm just thinking that basically all patients are put on coumadin because they are in such a high risk group. If the eye specialists note a substantial amount of coumadin patients with BRVT then maybe it is micro-emboli from a valve?

Regardless, I hope it soon clears up for you.

Thanks all. Betty you bring up a very interesting point which neither I or my doctors have thought about. The conventional wisdom states that BRVT is due to hypertension,diabetes, and/or high cholesterol. I have none of these
risk factors.Please don't feel sorry for me. I still correct down to 20/20 in my left eye. I can work, drive, and nothing hurts! I count my blessings.

 

[hensylee]

Marty, I am sorry to hear this is not straightening itself out. I just hope that it doesn't get any worse.

My brother is on coumadin. Took him to eye dr last month. Brother complains of blurring. The dr says there is a tiny scar on the eye (I suppose from cataract surgery) and the scar should probably be removed to clear the blur but brother has turned them down twice now. Perhaps this is a wise decision because of bleeding involved. you think?

 

[Marty]

Marty, I am sorry to hear this is not straightening itself out. I just hope that it doesn't get any worse.

My brother is on coumadin. Took him to eye dr last month. Brother complains of blurring. The dr says there is a tiny scar on the eye (I suppose from cataract surgery) and the scar should probably be removed to clear the blur but brother has turned them down twice now. Perhaps this is a wise decision because of bleeding involved. you think?

Hensylee, this is a tough decision and can only be made by your brother. I personally lean toward no additional eye surgery if he can live with the blurring.Now that most of our friends are agewise high 70's or 80's we have heard too many stories about bad results even after simple cataract surgery. When I asked my eye surgeon how he would handle my cataracts( yes, I have one in my good left eye) he said "very carefully" but he would not stop coumadin.