Sunday, January 10, 1999

Study links vision loss, stroke

Some forms have mutation in common

The Cincinnati Enquirer

        A Cincinnati-area research team has found that many people who suddenly lose vision from a condition called retinal vein occlusion have genetic mutations that also make them more likely to suffer strokes and other blood clot problems.

        The study, published in the January issue of Archives of Ophthalmology, was conducted by Dr. Charles Glueck, director of the Jewish Hospital Cholesterol Center, and seven other local researchers.

        More than 9 million Americans are blind or severely visually impaired (unable to read standard sized print even with corrective lenses), according to the American Federation for the Blind.

        Retinal vein occlusion is one of several less common causes of blindness. Unlike the gradual loss of vision that occurs from leading causes of blindness such as macular degeneration or cataracts, retinal vein occlusion strikes suddenly.

        “People can literally go to sleep one day with normal vision then wake up the next day blind in one eye,” Dr. Glueck said.

        While most common in people over 60, the condition can strike at younger ages. For example, a retinal blood clot, apparently triggered by a case of glaucoma, ended the career of Minnesota Twins baseball star Kirby Puckett in 1996.

        The condition occurs when a blood clot lodges in veins leading away from the retina. As a result, blood pressure in the eye soars and the oxygen supply plummets, causing permanent damage to the retina's sight-providing rods and cones.

        The Jewish Hospital study compared 17 Tristate patients with retinal blood clots to a control group of more than 200 healthy people. It found that patients with the eye problem were more likely to have one of three genetic mutations linked to blood clotting, especially one called factor V Leiden.

        The findings indicate that people who suffer from retinal vein occlusion should get genetic testing to measure their clotting risk, Dr. Glueck said.

        If the mutation is present, the patient is several times more likely to get a clot in their second eye, or in blood vessels leading to the heart, brain and other parts of the body, Dr. Glueck said. For women with the mutation, the risk of blood clots increases even more if they takes estrogen replacement therapy or birth control pills.

        Once people with the genetic risk are identified, doctors can attempt various clot-preventing therapies to avoid further complications, Dr. Glueck said.


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