Central Retinal Vein Occlusion in a Young Adult During Risperidone Therapy

Ağca, Alper; Bayraktar, Zerrin; Çakr, Mehmet; Bayraktar, Şükrü; Ekinci, Özalp; Ylmaz, Ömer Faruk

doi:10.1097/icb.0b013e3180601196

Cited by 5 publications

(4 citation statements)

References 4 publications

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“…Medications such as diuretics,3,34 sympathomimetics,3,35,36 oral contraceptives, 3,5,37 and antipsychotics38 have been linked to the development of the disease. These may result in hemoconcentration, thrombophilia, or dehydration,3,15 which precipitate its development.…”

Section: Discussionmentioning

confidence: 99%

Central Retinal Vein Occlusion in a Young Chinese Population

Kuo

Lai²,

Ong³

et al. 2010

Retina

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Purpose-The purpose of this study was to assess the risk factors for central retinal vein occlusion and associated morbidity and mortality in a Chinese population. Methods-The participants included patients with central retinal vein occlusion 40 years old and younger. Predisposing factors, mortality, and systemic complications were examined in this group.Results-Unilateral (n = 19) and bilateral (n = 3) central retinal vein occlusions were identified in a total of 22 patients (25 eyes), with a mean follow-up time of 37 months. Hypercholesterolemia (65%), hypertriglyceridemia (64%), and hyperhomocysteinemia (42%) were all identified as risk factors. Three patients (14%) developed stroke and 1 (5%) developed transient ischemic attacks during follow-up. Renal failure and pulmonary hypertension resulted in the death of two patients. The mean initial and final visual acuities (±standard deviation) were 20/400 (±20/250) and 20/500 (±20/320), respectively, and treatments did not result in vision improvement (P = 0.57). The poor visual prognosis was likely due to macular edema in 7 eyes (28%), optic atrophy in 4 eyes (16%), and secondary glaucoma in 3 eyes (12%). The majority of CRVO studies in younger patients have been conducted on Caucasians. 2-5, 7,9-26 Previous CRVO studies in patients of Chinese descent have not targeted younger patients. [27][28][29][30] Hence, clinical features, predisposing factors, visual outcomes, and mortality are not well established for the latter group. The aim of this study is to investigate predisposing risk factors and associated morbidity and mortality in young Chinese CRVO patients. Conclusion-Morbidity MethodsWe conducted a retrospective case review of CRVO patients 40 years old or younger treated in Chang Gung Memorial Hospital in Taiwan between January 2000 and December 2007. Patient data were collected after approval by the hospital's institutional review board. By using the ICD9 diagnosis code 36235 (CRVO) and using the criterion of 40 years old and younger, a total of 103 patient records were retrieved from our hospital's database. After excluding patients with follow-up <6 months and with hemi-CRVO or other retinal vessel occlusion diseases, a total of 22 patient records were collected for this study.Patient data collected included age, sex, associated medical history, previous ocular history, body mass index (BMI), visual acuity, intraocular pressure, anterior and posterior segment abnormalities, fluorescein angiography, ocular coherence tomography (in cases of macular edema), laboratory findings, other clinical tests, treatment, and morbidity and mortality. A detailed case workup with clinical consultations from the cardiology, neurology, endocrinology, and rheumatology services was recommended if CRVO was the sole complaint at initial presentation with no other medical history.The age at initial CRVO diagnosis was designated as current age, and ischemic CRVO was classified according to clinical signs, such as the presence of relative afferent pupillary defect, mar...

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Section: Discussionmentioning

confidence: 99%

Central Retinal Vein Occlusion in a Young Chinese Population

Kuo

Lai²,

Ong³

et al. 2010

Retina

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“…A search of PubMed with the keywords “central retinal vein occlusion and antipsychotic drug” and “branch retinal vein occlusion and antipsychotic drug” yielded only three publications, by Taki et al [ 7 ], Agca et al [ 15 ], and Yong et al [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Central retinal vein occlusion in a patient using the antipsychotic drug olanzapine: a case report

et al. 2021

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Background We report our findings in a patient who developed central retinal vein occlusion (CRVO) and was a chronic user of olanzapine, an antipsychotic medication. Case presentation A 50-year-old Caucasian man, non-smoker, was referred to our clinic with the chief complaint of floater appearance in his left eye for the past 3 days. His past medical history indicated that he had been taking antipsychotic drugs (olanzapine) for about 3 years, with no other systemic disease or risk factors for CRVO. In the examination, his best-corrected visual acuity (BCVA) was 0.7 in the left eye. The fundus showed signs of nonischemic CRVO with subhyaloid hemorrhage and intraretinal hemorrhage in the posterior pole and superior and inferior retina, without macular edema, confirmed by optical coherence tomography (OCT). We ruled out other probable differential diagnoses and risk factors which lead to CRVO through a complete physical exam and blood analysis (complete blood count, glucose, urea, creatinine, lipid profile, erythrocyte sedimentation rate, C-reactive protein, prothrombin time, partial thromboplastin time, Bleeding time (BT), fibrinogen level, proteins, antiphospholipid antibodies, homocysteine blood level, antithrombin III, protein C and S, factor V Leiden, prothrombin mutation, angiotensin-converting enzyme level, other autoantibodies, and human leukocyte antigen [HLA]-B51). Finally, we confirmed the probable side effect of olanzapine in CRVO, which has not been previously reported. A possible pro-thrombogenic mechanism of olanzapine at the molecular level is an affinity for 5-HT2Aserotonin receptors. Blocking these receptors results in increased platelet aggregation and increased blood coagulability. Conclusions These results indicate that CRVO can be a complication of chronic use of antipsychotic medications such as olanzapine, as shown for the first time in our case report. Clinicians should question patients who develop a sudden CRVO whether they are using antipsychotic medications such as olanzapine.

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“…Since then, reports were published linking retinopathy to different types of antipsychotics use such as thioridazine [4], phenothiazines [5][6][7][8], chlorpromazine [9], haloperidol [10] and clozapine [11]. Risperidone was linked to retinal artery occlusion in one case report [12], central retinal vein occlusion in another [13] and macular edema in a more recent report [14].…”

Section: Discussionmentioning

confidence: 99%

Dopamine dilemma: case report of treating psychosis in patient with retinitis pigmentosa

Salem¹,

Klassen²,

Elkhatib³

et al. 2019

Psychiatry and Clinical Psychopharmacology

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Retinitis Pigmentosa is a rare inherited degenerative eye disease affecting the retinal pigment epithelium (RPE), in which mutation of rhodopsin leads to severe visual impairment, and legal blindness. The D4 receptors are abundant within the rods of the retina and dopamine release is the primary feedback mechanism preventing retinal degeneration by the unopposed action of melatonin. Here, we present a 50-year-old female patient with schizophrenia and retinitis pigmentosa who was admitted to an inpatient unit for an acute psychotic exacerbation with agitation and persecutory delusions. Patient initially was administered IM haloperidol since she refused oral form, but she eventually was compliant to oral Haloperidol with eventual reduction in daily dose to 5mg/d with treatment response and good tolerability including no change in visual acuity. The treatment of psychosis in patients with retinitis pigmentosa is challenging and requires consideration of the potential D4 receptor effects associated with an antipsychotic medication to prevent further retinal damage.

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Central Retinal Vein Occlusion in a Young Adult During Risperidone Therapy

Abstract: The use of risperidone may be a risk factor for CRVO.

Cited by 5 publications

References 4 publications

Central Retinal Vein Occlusion in a Young Chinese Population

Central Retinal Vein Occlusion in a Young Chinese Population

Central retinal vein occlusion in a patient using the antipsychotic drug olanzapine: a case report

Dopamine dilemma: case report of treating psychosis in patient with retinitis pigmentosa

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