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H. T. Rahman, P. E. Carvounis, E. R. Holz; Central Retinal Vein Occlusions Treated With Enoxaparin. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5387.
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To describe the successful treatment of acute and subacute unilateral central retinal vein occlusions (CRVOs) with weight based enoxaparin (Lovenox, Sanofi-Aventis, Collegeville, PA) subcutaneously every 12 hours.
In a retrospective, non-comparative, consecutive case series, four patients with acute or subacute unilateral CRVOs were treated with enoxaparin 1mg/kg subcutaneously every 12 hours for at least 1 month. Main outcome measures included visual acuity, venous caliber, intraretinal hemorrhages, neovascularization, and macular edema by clinical ophthalmoscopy and optical coherence tomography (OCT).
Baseline visual acuity on initiation of enoxaparin therapy ranged from 20/25 to count fingers vision. After treatment, all 4 patients showed significant improvement in visual acuity ranging from 20/15 to 20/100. Two patients had complete resolution of their macular edema while the remaining two patients had significantly improved macular edema as measured by OCT. All patients had complete resolution or significant improvement of venous caliber and intraretinal hemorrhages. No patients developed neovascularization or adverse bleeding outcomes.
Subcutaneous, weight based, enoxaparin twice daily may be an effective means to improve visual acuity, improve macular edema, and prevent neovascularization in acute and subacute CRVOs. Further study through a larger clinical trial is warranted.
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