Hi I'm Dr. JP. I'm here to help answer your questions today. Give me a moment to review your post.
1) does januvia cause central retinal vein thrombosis?
There are no published cases of januvia (used for diabetes) causing CRVO.
2) can plavix be prophylactically used in central retinal vein thrombosis to prevent often associated central retinal artery occlusion?
There have been studies looking at antiplatlet therapy for the prevention of CRVO. However the jury is still out with regard to making this a standard practice. Currently most ophthalmologist recommend a baby aspirin a day, good diabetic control, good blood pressure control and lowering cholesterol.
3) do these activitis increase or cause central retinal vein thrombosis or rupture of retinal veins? sleep apnea, constipation and straining and violent sneezing?
constipation, straining and violent sneezing have been associated with intraocular hemorrhages but not with the cause of CRVO. Now sleep apnea has been associate with increasing the risk of CRVO events.
-painless loss of vision typically unilateral
-Atherosclerosis of the adjacent central retinal artery compresses the central retinal vein in the back of the eye (at the optic nerve, lamina cribosa). This causes thrombosis in the lumen of the vein.
Associate risk factor for CRVO events:
-optic nerve swelling
-optic disc drusen
-hypercoagulable state: ie polycythemia vera, leukemia, sickle cell disease, multiple myeloma, antiphospholipid syndrome.....
-abnormal platlet funciton
-tumors behind the eye that compress the optic nerve
-thyroid eye disease
-migraine, very rarely
-fluoroscein angiogram of the retina
-in on diuretics for blood pressure control talke with your doctor to switch to another class
-lower intraocular pressure, if you have glaucoma or have elevate pressures without glaucoma
-treat diabetes, cholesterol
-frequent eye exams initially as the eye can develop neovascularization necessitating need for laser treatment. also many patient with CRVO develop macular (central retina) edema (swelling). This can be treated with steroid injections and laser, however the results are not typically an improvement in vision. But there are case that improve, mostly those with good foveal circulation.
-aspirin 81mg per day, please note that this is unproven, it's only theoretical
A CRVO event in the contralateral eye is said to be 10%. So it's important to get an examination by your eye doctor and your primary care doctor. They will treat any risk factors in order to prevent another event in the other eye.
It was a pleasure chatting with you. I hope this information is helpful. Is there anything else I can do?
If you would be so kind as to leave feedback, I'd really be appreciative.