Retinal Vein Occlusions after Use of Rofecoxib (VIOXX)
Meyer C. H.1, Gähler R.2, Schmidt J. C.1
Department of Ophthalmology1 and Department of Anesthesiology2, Philipps University Marburg
Purpose: After the use of rofecoxib (VIOXX), a nonsteroidal anti-inflammatory drug, a greater incidence of cardiovascular thrombotic events has been reported. Rofecoxib, a selective cyclooxygenase (COX)-2 inhibitor, may increase the platelet aggregation by inhibiting the thromboxane A2 production.
Method: We present two patients with branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO) by medical history, fluorescein angiography and fundus photography after application of rofecoxib.
Results: A 72-year-old female with rheumatoid arthritis was treated with rofecoxib. When the dosage was doubled to 50mg daily, she noticed a sudden painless decrease of vision in her right eye. Biomicroscopy OD demonstrated a CRVO with tortuous retinal veins and numerous flecked hemorrhages in the midperiphery. A 68 year-old female with severe osteoporosis developed a BRVO 1 day after taking rofecoxib (25mg) daily.
Conclusions: Although COX-2 inhibitors are safe in the majority of patients, they may induce prothrombortic effects under certain conditions. Few patients with predisposed thrombosis may be at risk for cardiovascular and ocular thrombotic events.
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