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Central Retinal Vein Occlusion +From: Terrence.Jones@ncal.kaiperm.orgMon Oct 30 14:39:00 1995
EXPERIENCE: none OPINION: Might be helpful to distinguish between VASCULAR vs BAROTRAUMA etiologies. VASCULAR - might include vasculitis, both postinfectious and immunologic; and are less likely related to HRT effects. On the other hand, thrombophilia (including rheologic {hyperlipidemia/hypertriglyceri- demia}, and acquired {diabetic retinopathy/antiphospholipid syndrome} or congenital {protein c/s, AT-III, Leiden factor V (resistance to activated protein C - recently presented for discussion here on our list)}) -- may well be influenced by HRT. This may be particularly related to mode of estrogen administration (hepatic cofactor & triglyceride production). BAROTRAUMA - or microbubble air emboli secondary to less than optimal decompression, can occur sporadically, and unpredicatably at times, (particularly, even at quite shallow depths in pts. with asthma - which she likely does not have). This would likely present shortly following a dive, and may be assoc with other vaso-occlusive phenomena. It would not be likely to be related to HRT. ADVICE: Insure the input of an interested Ophthalmogist. May be some role for color doppler in determinig etiology, as well as recurrence rates both ipsi-, and contralaterally. ADDITIONAL POINT: Regarding air embolism (+/- doppler!) anybody have any comments regarding findings from Sept. 1993 Anesth.Analg. (Vol 77: 448-52), regarding rel. high incidence during c/s? Terry Jones Kaiser, SF (KSF)
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