Posters

Central retinal vein occlusion associated with use of tranexamic acid

Poster Details

First Author: A.Alshahrani SAUDI ARABIA

Co Author(s):    T. Algamdi                    

Abstract Details

Purpose:

The aim to discover a rare case of central retinal vein occlusion(CRVO) that developed after use the tranexamic acid. It work as anti-fibrinolytic agent that is used to control the  menses bleeding especially the heavy menstrual bleeding But thrombotic event can occur as serious side effect of this medication particularly with high dose or long term use of tranexamic acid therapy.

Setting:

AFHSR - Saudi Arabia.

Methods:

A 46-year-old female dentist, medically free. She complained of left eye blurred vision since she woke up. She used tranexamic acid before this attack frequently. She did not take any medication before.Our examination revealed visual acuity was 6/24 left eye and 6/6 right eye. Pupils were reacting both eyes with no relevant afferent pupillary defect. Anterior segment were normal in both eyes, Anterior chamber were quit without neovascularization of iris/angel,intraocular pressure:14/16. Fundus of left eye showed flam shaped hemorrhages in all four quadrants, disc swelling, venous tortuosity,macular edema, but no neovascularization of disc or elsewhere detected. Normal right fundus.

Results:

We did complete laboratory workup and the result were normal. So,we treat the macular edema  by intravitreal ranibizumab (lucentis) (0.5 mg\ml) twice in one month apart. We stop the tranexamic acid to prevent another attack in the fellow eye. After one month of the first intravitreal ranibizumab injection, The visual acuity improved to 6/12 , Then the second injection was given and after four weeks the visual acuity improved to 6/9 and macular edema improved. After 7 months of continuous follow up in ophthalmology clinic, the pathological changes of fundus were normalized and visual acuity 6/6 both eyes with correction.

Conclusions:

Central retinal vein occlusion (CRVO) after using the tranexamic acid is a rare condition. Blood vessel occlusion including CRVO can be a side effect of tranexamic acid particularly if it exceeds the maximum recommended daily dose or if it is used for prolonged period, especially in hematological disorder patients. Early diagnosis and management of CRVO secondary to tranexamic acid will give a better outcome as seen in our case. Therefore, we should consider it as one of the causes of CRVO but further studies are required to establish this relationship.The author has no financial interest.

Financial Disclosure:

None.

Financial Disclosure:

None