Fibrinolytic activity in retinal vein occlusion

• Published in: International ophthalmology 1997, Vol.21 (6), p.343-348
• Main Authors: Abu El-Asrar, A M, Abdel Gader, A G, Al-Amro, S, Al-Momem, A K
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biomarkers - blood; Clot Retraction; Female; Fibrinolysis - physiology; Fluorescein Angiography; Follow-Up Studies; Fundus Oculi; Humans; Male; Middle Aged; Plasminogen Inactivators - blood; Prospective Studies; Retinal Vein Occlusion - blood; Retinal Vein Occlusion - diagnosis; Retinal Vein Occlusion - etiology; Serum Globulins - metabolism; Tissue Plasminogen Activator - blood; Visual Acuity
• ISSN: 0165-5701
• DOI: 10.1023/A:1006075815099

Impaired fibrinolytic function is a common finding in patients with thrombotic disease. The present study was initiated to evaluate the fibrinolytic response to a venous occlusion test (VOT) in patients with retinal vein occlusion. Euglobulin clot lysis time (ECLT), tissue plasminogen activator (t-PA) activity, and plasminogen activator inhibitor (PAI) activity were measured before and after VOT in a group of 26 consecutive patients presenting with retinal vein occlusion and in 15 healthy age- and sex-matched controls. Before VOT (baseline), a higher proportion of patients (54%) had an ECLT of more than 5 h compared with controls (6.7%) (p = 0.0027) indicating decreased overall fibrinolytic activity. Patients had non-significantly lower t-PA and higher PAI activities compared with controls. After VOT, a higher proportion of patients (34.6%) had an ECLT of more than 5 h compared with controls (6.7%) (p = 0.05). Patients had significantly lower t-PA activity (p = 0.0232) and significantly higher PAI activity (p = 0.0292). Subgroup analysis revealed that patients with an ECLT of more than 5 h had significantly higher levels of PAI activity at baseline (p = 0.0326) and after VOT (p = 0.0184) compared with patients with an ECLT of less than 5 h. However, t-PA activity was significantly higher (p = 0.0153) at baseline, and non-significantly higher after VOT in patients with an ECLT of more than 5 h when compared with patients with an ECLT of less than 5 h. These findings suggest that impaired fibrinolysis due to increased PAI activity may play a role in the pathogenesis of retinal vein occlusion.