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Bleeding in retinas - anyone have info?


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Steve had WBR ending in 3/04. He has been on Iressa since the end of July and MRI and CT scans within the last month have shown him to be stable. He also has been on Aredia or Zometa since about 9/04.

He has had a sudden severe vision loss. Opthamologist found severe bleeding/edema in both retinas posteriorally. No cataracts and other parts looked ok. He contacted a retinal specialist who also seemed puzzled, but he will probably see Steve on Monday.

Any ideas what could be causing this? Any questions we should be asking? Really appreciate your input as this has really thrown us in a spin. Thanks for any help!

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Is Steve taking any herbs like ginko or ginseng with aspirin or on any blood thinners. I read that this may cause bleeding in the eye.

Is his blood pressure high or does he have diabetes?

If there are any blood clots, this may cause it. The Dr could test his INR to check the blood

I would tell his doctors about his eye problems in addition to the eye Dr if you have not already

I really don't know what it could be though

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Hi John,

Thanks for getting back to me and for the suggestion to also make sure his oncologist knows what's happening. We saw a retina specialist today. Steve has been a well-controlled Type 2 diabetic for 7 years with no previous evidence of eye damage. But the specialist believes that the diabetes "set the stage" for damage from radiation. I didn't know that radiation retinopathy can show up from 6 mos. -2 years after radiation. Steve is a bit early for that, but he still think that's what it is. More pictures this p.m. then they will see what they can do to at least control the swelling. Maybe some laser surgery too. Additionally, the possibility that it is uncorrectable and possibly progressive. Sure hope not, he already can no longer read. What a setback - and today is his birthday :(

Thanks again John!

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Wow, that is pretty strange, I have never seen this happen before. Do they think it is possible that he had acceleration of diabetic retinopathy from steroid use? That would definitely be the most common cause of retinal hemorrhage although getting it in both eyes at the same time would be unusual. The only time I have seen anything like this was a patient who developed a cavernous sinus thrombosis that resulted in venous bleeding in both retinas. That would show up on an MRI but has a typical appearance with the ophthalmoscope (I actually started out in ophthalmology before switching career paths to oncology...).

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