PMID- 34049568
OWN - NLM
STAT- MEDLINE
DCOM- 20210601
LR  - 20210602
IS  - 1752-1947 (Electronic)
IS  - 1752-1947 (Linking)
VI  - 15
IP  - 1
DP  - 2021 May 29
TI  - Central retinal vein occlusion in a patient using the antipsychotic drug 
      olanzapine: a case report.
PG  - 307
LID - 10.1186/s13256-021-02865-8 [doi]
LID - 307
AB  - BACKGROUND: We report our findings in a patient who developed central retinal 
      vein occlusion (CRVO) and was a chronic user of olanzapine, an antipsychotic 
      medication. CASE PRESENTATION: A 50-year-old Caucasian man, non-smoker, was 
      referred to our clinic with the chief complaint of floater appearance in his left 
      eye for the past 3 days. His past medical history indicated that he had been 
      taking antipsychotic drugs (olanzapine) for about 3 years, with no other systemic 
      disease or risk factors for CRVO. In the examination, his best-corrected visual 
      acuity (BCVA) was 0.7 in the left eye. The fundus showed signs of nonischemic 
      CRVO with subhyaloid hemorrhage and intraretinal hemorrhage in the posterior pole 
      and superior and inferior retina, without macular edema, confirmed by optical 
      coherence tomography (OCT). We ruled out other probable differential diagnoses 
      and risk factors which lead to CRVO through a complete physical exam and blood 
      analysis (complete blood count, glucose, urea, creatinine, lipid profile, 
      erythrocyte sedimentation rate, C-reactive protein, prothrombin time, partial 
      thromboplastin time, Bleeding time (BT), fibrinogen level, proteins, 
      antiphospholipid antibodies, homocysteine blood level, antithrombin III, protein 
      C and S, factor V Leiden, prothrombin mutation, angiotensin-converting enzyme 
      level, other autoantibodies, and human leukocyte antigen [HLA]-B51). Finally, we 
      confirmed the probable side effect of olanzapine in CRVO, which has not been 
      previously reported. A possible pro-thrombogenic mechanism of olanzapine at the 
      molecular level is an affinity for 5-HT(2A)serotonin receptors. Blocking these 
      receptors results in increased platelet aggregation and increased blood 
      coagulability. CONCLUSIONS: These results indicate that CRVO can be a 
      complication of chronic use of antipsychotic medications such as olanzapine, as 
      shown for the first time in our case report. Clinicians should question patients 
      who develop a sudden CRVO whether they are using antipsychotic medications such 
      as olanzapine.
FAU - Nowrouzi, Ali
AU  - Nowrouzi A
AUID- ORCID: 0000-0001-7326-091X
AD  - Ophthalmology Department of Hospital universitario SAS Jerez de la Frontera, 
      Jerez de la Frontera, Spain. alinoroozi_co@yahoo.com.
FAU - Kafiabasabadi, Sepideh
AU  - Kafiabasabadi S
AD  - Western University Collage of Dental Medicine, Pamona, California, USA.
FAU - Rodriguez-Calzadilla, Mario
AU  - Rodriguez-Calzadilla M
AD  - Ophthalmology Department of Hospital universitario SAS Jerez de la Frontera, 
      Jerez de la Frontera, Spain.
FAU - Benitez-Del-Castillo, Javier
AU  - Benitez-Del-Castillo J
AD  - Ophthalmology Department of Hospital universitario SAS Jerez de la Frontera, 
      Jerez de la Frontera, Spain.
FAU - Soto-Guerrero, Alejandro
AU  - Soto-Guerrero A
AD  - Ophthalmology Department of Hospital universitario SAS Jerez de la Frontera, 
      Jerez de la Frontera, Spain.
FAU - Diaz-Ramos, Antonio
AU  - Diaz-Ramos A
AD  - Ophthalmology Department of Hospital universitario SAS Jerez de la Frontera, 
      Jerez de la Frontera, Spain.
FAU - Marques-Cavalcante, Kyara Vaneska
AU  - Marques-Cavalcante KV
AD  - Ophthalmology Department of Hospital general Universitario de Alicante, Alicante, 
      Spain.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20210529
PL  - England
TA  - J Med Case Rep
JT  - Journal of medical case reports
JID - 101293382
RN  - 0 (Antipsychotic Agents)
RN  - N7U69T4SZR (Olanzapine)
SB  - IM
MH  - *Antipsychotic Agents/adverse effects
MH  - Humans
MH  - *Macular Edema
MH  - Male
MH  - Middle Aged
MH  - Olanzapine/adverse effects
MH  - *Retinal Vein Occlusion/chemically induced
MH  - Visual Acuity
PMC - PMC8164284
OTO - NOTNLM
OT  - Antipsychotic drug
OT  - Central retinal vein occlusion
OT  - Macular edema
OT  - Olanzapine
OT  - Venous thromboembolism
COIS- The authors declare that they have no competing interests and confirm that all 
      relevant data are included in the case presentation.
EDAT- 2021/05/30 06:00
MHDA- 2021/06/02 06:00
PMCR- 2021/05/29
CRDT- 2021/05/29 05:28
PHST- 2020/04/09 00:00 [received]
PHST- 2021/04/15 00:00 [accepted]
PHST- 2021/05/29 05:28 [entrez]
PHST- 2021/05/30 06:00 [pubmed]
PHST- 2021/06/02 06:00 [medline]
PHST- 2021/05/29 00:00 [pmc-release]
AID - 10.1186/s13256-021-02865-8 [pii]
AID - 2865 [pii]
AID - 10.1186/s13256-021-02865-8 [doi]
PST - epublish
SO  - J Med Case Rep. 2021 May 29;15(1):307. doi: 10.1186/s13256-021-02865-8.