The Risk of Venous Thrombosis in Patients Using Hormone Replacement Therapy

A healthy 75 year old female patient active in fitness and on hormone replacement therapy presented with mild meibomian gland dysfunction and desiccation of the conjunctival surface. In addition, the posterior pole was remarkable for arteriolar nicking in a few areas in both the right and left eyes, no signs of vascular occlusion. Both the retina and macula look very healthy overall. However, patient is at risk for developing vascular occlusion.

Exam shows retinal venous tortuosity.

Studies show that women participating in hormone replacement therapy (HRT) have an increased risk of venous thrombosis compared to those who do not use HRT. The risk depends according to differing factors, such as the type of estrogen, delivery of the estrogen and predisposed factors. (Wu, 2005)