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Retinal vein thrombosis associated with a herbal phytoestrogen preparation in a susceptible patient

Rheumatic Diseases Unit, Royal Liverpool University Hospital NHS Trust, Liverpool, UK

Correspondence to:
Correspondence to:
Dr J L Cheong
Rheumatic Diseases Unit, Link 7Z, Royal Liverpool University Hospital NHS Trust, Prescot Road, Liverpool L7 8XP, UK; jelai_cheong{at}hotmail.com

A 55 year old woman, known to have systemic lupus erythematosus and protein S deficiency, presented with sudden onset of visual loss in the left eye. Three days previously, she took a herbal phytoestrogen preparation for relief of her menopausal symptoms. Ophthalmological assessment showed a left inferior hemiretinal vein thrombosis. The temporal relation between the onset of visual symptoms and ingestion of this herbal preparation suggested that in this patient with a prior non-manifest prothrombotic tendency, there may be an association between the development of retinal vein thrombosis and herbal phytoestrogen use.

Keywords: herbal phytoestrogen; oestrogen; protein S; retinal vein thrombosis; systemic lupus erythematosus

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