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Eye clot in Central Vein
Mar 30, 2004

Problem: 42y male with clot in the Central Vein of Right Eye causing impaired vision. Recent visit to eye doctor with multiple labs and diagnostics ordered. Echocardiogram normal. Bilateral Carotid Ultrasounds normal. Lipid Panels normal. Other clotting studies normal except that the Factor 8 assay is elevated at 248 (normal 70-150)

Brief Hx: HIV + >10 years, HAART with Fuzeon, sclerosing cholangitis, esophageal varices banded without recurrence (blood transfusions/sandostatin treatment when acute, inderal therapy current), Hepatitis B exposure, Pneumonia over 8 years ago, prior history of thrombocytopenia

CD4 count: 165 Viral Load: 4000

My question: What could possibly be causing the clotting problem? It appears I am not a candidate for anticoagulation due to the history of varices. Any help or advice on how to proceed would be appreciated.

Response from Dr. Henry

HIV can be associated with hypercoagulable state. I assume the platelet count is OK. I have seen a couple of cases of that without any explanation-diabetes, glaucoma, and high blood viscosity (i.e. high hematocrit) can contribute. If patients have OK retinal vessel perfusion the vision can do OK. Photocoagulation to involute secondary retinal vascular growth is sometimes used to decrease complications. KH



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