Can estrogen deficiency cause retinal hemorrhage?

1. Retinal Vein Occlusion: Patients often have a history of hypertension and arteriosclerosis, and clinically present with sudden vision loss or blurred vision. Fundus examination reveals extensive patchy or flame-shaped hemorrhages in the area of venous occlusion, accompanied by retinal edema and exudates. When a branch of the retinal vein is occluded, hemorrhage is generally confined to the local region of the affected vein; however, when the central retinal vein is occluded, the fundus hemorrhage is widespread and severe. If the macular area is involved in branch retinal vein occlusion or if central retinal vein occlusion occurs, patients may experience significant vision loss. 2. Diabetic Retinopathy: Patients have a history of diabetes mellitus, although some diabetic individuals may be unaware of their condition. Diagnosis can be confirmed through blood glucose testing. Fundus hemorrhage in diabetic retinopathy develops progressively. In early stages, only a few dot hemorrhages and microaneurysms may be observed. As the disease progresses, dot hemorrhages and exudates become more prominent. Most patients remain asymptomatic at this stage. Once the disease advances to the proliferative stage or macular edema develops, patients may begin to experience vision decline. If neovascularization leads to substantial preretinal or vitreous hemorrhage, patients typically suffer sudden vision loss, sometimes reducing vision to only light perception or hand motion in severe cases. 3. Age-Related Macular Degeneration: In age-related wet macular degeneration, fundus hemorrhage is typically confined to the macular region, and patients are usually over 50 years of age. The clinical presentation includes sudden vision loss, primarily affecting central vision. Optical coherence tomography (OCT) reveals subretinal neovascularization (choroidal neovascularization, CNV). In advanced wet AMD, large areas of subretinal hemorrhage may occur, and even vitreous hemorrhage, leading to more severe visual impairment. 4. Other Causes: Systemic diseases such as hypertensive retinopathy, nephropathic retinopathy, and hematologic disorders can all lead to fundus hemorrhage. Ocular conditions including retinal tears and ocular trauma may also cause retinal bleeding. Only by accurately identifying the underlying cause of fundus hemorrhage can targeted treatment be effectively implemented. Large amounts of retinal hemorrhage caused by any of the above conditions may extend forward into the vitreous cavity, resulting in vitreous hemorrhage. This is a common cause of vitreous opacities, vitreous organization, traction on the retina, and subsequent retinal detachment. Fundus hemorrhage is one of the objective signs of either systemic disease or ocular pathology. Once signs of retinal hemorrhage are detected, ophthalmologists typically recommend comprehensive evaluation of both ocular and systemic conditions to determine the etiology. Treatment should not only focus on stopping the bleeding and promoting absorption of hemorrhagic products, but also address the underlying systemic diseases that triggered the bleeding.