Doctors fix blood clot in eye using stroke drug
Thomas Reisenauer already had one bad eye, so he was alarmed when he woke up one morning and his good eye was giving him trouble. He had no idea he would wind up as a case study.
“I was up at the lake, Priest Lake,” said Reisenauer, a 74-year-old retired mechanic. “I saw kaleidoscope figures dancing on the walls. Except it wasn’t colors. It was yellow on a white wall. I was sleeping down in the boathouse, so I walked up the stairs and made coffee and they kept getting worse.”
Reisenauer headed to Spokane and saw Dr. Steven Day, an eye doctor. It turned out Reisenauer had a blood clot in his left eye, more specifically, in the artery feeding his retina, the layer of the eye that receives and sends focused images. If the clot wasn’t broken up soon, if blood flow wasn’t restored to the retina, he might lose his vision.
Conventional therapy, such as applying pressure to the eye or putting the patient in a bariatric chamber, isn’t very successful. Day found a medical journal article about a small study of 12 patients in which doctors tried something different. He consulted with Dr. Hal Goldberg, a Spokane cardiologist. They decided to try it themselves.
Tissue plasminogen activator (tPA) is a drug normally used for stroke and heart attack patients. In consultation with Day, Goldberg administered tPA intravenously.
Their patient’s vision cleared significantly within two hours and was close to normal within a week.
Goldberg thinks this may be the first time tPA was used for a blood clot in the eye in Spokane, and possibly the state. He’d like to see a randomized, controlled study.
“The use of this medication has raised the possibility of establishing a citywide (and possibly statewide) experimental protocol for use of this medication to evaluate, in a prospective randomized fashion, conservative treatment vs. intravenous tPA. It is important to carry out a trial in this fashion to be certain scientifically that the medication is effective and that all side effects of treatment (in particular stroke in a patient with this medication) are revealed,” Goldberg said in an e-mail.
Reisenauer now wears dark glasses outside because his eye is sensitive to strong light. But he can see.
“I guess I was the guinea pig,” he said. “Anyway, it worked.”
The rest of us can lower our risk of blood clots in the eye by controlling our blood pressure and quitting smoking.
Drug safety warnings
Here’s a new Web site to watch. Drug-warnings.com hopes to speed the delivery of prescription drug safety information to the public. It provides U.S. Food and Drug Administration safety alerts, recalls and warning information about prescription drugs. Find it at www.drug-warnings.com.
The people who put up the site hope eventually to recoup some money through Google ads. But until then, the site is “a labor of love,” said the Tennessee Web site developer who responded by e-mail to my inquiry and asked to remain anonymous because he has clients in the health-care industry.
The site was inspired, he said, because a friend was taking the diabetes drug Rezulin and didn’t find out it had been withdrawn from the market due to liver toxicity until a month after the fact.
“We don’t have any grudge against drug companies. Drug companies have saved more lives than any other entity in the world,” he wrote. “We mainly are concerned with the urge to medicate more often than actually needed and want people to be clear on the real possibility of adverse actions. We are not big fans of trial lawyers but have included information regarding malpractice and legal issues due to the high volume of e-mail. Our main goal is to help remind people that the human body is a complex organism and adding chemicals to correct a problem can, and does occasionally result in adverse reactions that can drastically alter their lives – despite rigorous testing.”
Carla K. Johnson can be reached at (509) 459-5148, or by e-mail at carlaj@spokesman.com. Read her blog online. Look for the link from www.spokesmanreview.com.