Components of the fibrinolytic system in the vitreous body in patients with vitreoretinal disorders

Abstract

Purpose: To assess components of the fibrinolytic system in the vitreous humour and serum of patients with vitreoretinal disorders. Methods: Forty‐three samples of vitreous humour and plasma of 43 patients undergoing pars plana vitrectomy for macular hole, macular pucker, retinal detachment or proliferative vitreoretinopathy were evaluated for their content of plasminogen, a2‐antiplasmin, plasminogen‐activator‐inhibitor 1, plasmin‐a2‐antiplasmin‐complex, tissue plasminogen activator, total protein, albumin, d‐dimer. Patient groups were compared with each other using the U‐test (Mann and Whitney) for non‐parametric testing of two independent samples. Results: The groups of retinal detachment and proliferative vitreoretinopathy had elevated vitreal levels of plasminogen‐activator‐inhibitor 1 (352.5 and 370.7 ng/mL vs. 1.86 and 56.6 ng/mL, P = non‐significant), plasmin‐a2‐antiplasmin‐complex (2416.5 and 1836.2 µg/L vs. 124.2 and 133.4 µg/L, P < 0.001), albumin (0.08 and 0.15 g/dL vs. 0.03 and 0.07 g/dL, P < 0.05) and d‐dimer (4.76 and 1.64 µg/mL vs. 0.40 and 0.48 µg/mL, P = non‐significant) when compared with patients with macular hole and macular pucker. Conclusions: There are significant differences in the vitreal concentration of components of the fibrinolytic system in patients with vitreoretinal disorders. Breakdown of the blood–retinal barrier and complex disease‐specific mechanisms are thought to be responsible for an increase of components of the fibrinolytic system in the vitreous.

Intravitreal Functional Plasminogen Is Elevated in Central Retinal Vein Occlusion

“…To the best of our knowledge, studies on intravitreal plasminogen activity in patients with CRVO have not been published so far. Ulrich et al [62] were not able to detect any plasminogen activity in vitreous samples in patients with and without BRB breakdown. In contrast, Esser et al [63] found a significant increase in vitreous plasminogen activities in patients with proliferative (diabetic) vitreoretinopathy (0.108-0.142 mg/ml; about 100%N) with a consecutive BRB breakdown in comparison to healthy controls (0.015 mg/ml; about 1%N), and plasminogen activities were correlated with the severity of diabetic vitreoretinal damage.…”

Intravitreal Plasmin Without Associated Vitrectomy as a Treatment for Refractory Diabetic Macular Edema

“…4,14,20,21 The average amount of APE obtained and injected in this method was 0.21 IU/0.2 mL (1.05 ± 0.12 IU/mL), but this dose was suffi cient to induce a complete vitreous detachment in the patients in this study. A recent article shows high intravitreal plasminogen levels in diabetic eyes, 22 so what we cannot be sure is if all the and control eye CMTs were 241.81 ± 47.9 μm and 530.375 ± 85.33 μm, respectively. There was a statistically significant difference (P < 0.001, bilateral Wilcoxon test for paired samples) between both groups.…”

Fibrinogen and rhegmatogenous retinal detachment: a pilot prospective study

“…Fibrinogen is known as a positive acute phase reactant. Histological examination of subretinal strands after RRD and immunostaining of early preretinal exudates and recently the increased level of fibrinolytic components in the vitreous, indicate fibrin/fibrinogen presence in eyes suffering with retinal detachment 9–11. Specific binding with collagen type IV is an additional significant observation 12.…”