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   Table of Contents      
ARTICLES
Year : 1977  |  Volume : 25  |  Issue : 3  |  Page : 5-8

Blood fibrinolytic studies in Eales's disease


Department of Ophthalmology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India

Correspondence Address:
K S Mehra
4 Medical Enclave, Banaras Hindu University, Varanasi-221005
India
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Source of Support: None, Conflict of Interest: None


PMID: 614275

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How to cite this article:
Pathak S D, Mehra K S, Dube B. Blood fibrinolytic studies in Eales's disease. Indian J Ophthalmol 1977;25:5-8

How to cite this URL:
Pathak S D, Mehra K S, Dube B. Blood fibrinolytic studies in Eales's disease. Indian J Ophthalmol [serial online] 1977 [cited 2020 Aug 3];25:5-8. Available from: http://www.ijo.in/text.asp?1977/25/3/5/31260

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Table 8

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Table 7

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Table 5

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Table 4

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Table 2

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Table 1

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Table 1

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Eales's disease, which is famous for its multifactorial aetiology, has kept us in dark about its aetiopathogenesis. Recently there have been several investigations on the function of the fibrinolysin in the living organism and the relationship between the fibrinolytic activity and various pathologic states.

The present study was undertaken to examine the fibrinolytic activity in patients of Eales's disease.


  Material and Methods Top


Group A: 40 normal cases, between the age group of 20-40 years, belonging to both the sexes, were taken as controls. The patients suffering from factors like mental stress, trauma, infections, affecting the fibrino­lytic activity, were not included in this study.

Group B: The patients, attending the out patients department of Bhuwalka Eye Hospital (S.S. Hospital), Banaras Hindu University, with the clinical diagnosis of Eales's disease were taken up for this study.

The general systemic and local examinations were made. Total and differential W.B.C. count, Hb%, E.S.R., Bleeding time, coagulation time, Prothrombin time, Hess's capillary fragility test, Platelet count and K.C.C.T. were done in patients belonging to both the groups.

Fibrinolytic activity was studied by:

1. Euglobulin lysis time-by the technique of Buckel as described by Biggs and Macfarlane.[2] The Euglobulin lysis time test more than 3 hours was considered as normal and less than this indi­cated raised fibrinolytic activity. When changed in units, if less than 55 it was considered as normal and above 55 as abnormal indicating raised fibrinolytic acti­vity.

2. Fibrin plate lysis was determined by the techni­que described by Astrup and Mullertz.[1]

In fibrin plate method area of lysis within 16-100 mm was considered as normal and more than 100 mm was considered to be due to raised fibrinolytic acti­vity.


  Observations Top


We studied 40 case of Eales's disease and 40 normal cases. The controls were thoroughly matched as regard to their age, sex, profession and socio-economic conditions.

Fibrinolytic activity in control and Eales's disease cases: Euglobulin lysis time was more than 3 hours in all the normal cases (40 cases), while in Eales's disease group euglobulin lysis time was less than 3 hours in 37 cases while in 3 cases it was within normal range. [Table - 1].

Euglobulin Lysis time (in units) was less than 55 in all normal cases (within normal range) [Table - 2] and abnormal in 37 cases of Eales's disease group [Table - 3]. Area of lysis of fibrin was within 16-100 mm in all the normal cases [Table - 4], but it was raised in 85% of Eales's disease patients [Table - 5].

While comparing euglobulin lysis time and fibrin plate lysis between control and Eales's disease statistically highly significant difference was noted-fibrinolytic activity determined by both techniques was higher in Eales's disease group [Table - 6].

While comparing the euglobulin lysis time and fibrin plate lysis tests in Eales's disease group between cases with fresh haemorrhage and without haemorrhage statistically highly significant difference was observed more in patients who had presence of haemorrhage [Table - 7].

On comparing results of euglobulin lysis time and fibrin plate method between cases having fresh haemorrhages and old haemor­rhage, statistically highly significant difference was noted-the activity was raised in fresh haemorrhage cases [Table - 8]. It was also observed that more the number of attacks of vitreous haemorrhage more was the rise in fibrinolytic activity.


  Discussion Top


On going through the literature we find that fibrin plate method has not been employed for the purpose of determining fibrinolytic activity by any other worker on Eales's disease patients. Fibrin plate lysis in all our normal cases was within the normal range of 16-100 mm [Table - 4] while in 85% of Eales's disease patients it was raised [Table - 5] and p and t values showed significant difference in the two groups [Table - 6].

Euglobulin lysis time in group B cases (Sales disease-[Table - 3]) was found to be abnormal (increased fibrinolytic activity) in 92.5% of the cases [Table - 3]. Only 3 cases (7.5%) had normal euglobulin lysis time (more than 3 hours). p and t values showed significant difference -between the two groups [Table - 4].

Out of these 3 cases, who showed normal fibrinolytic activity 2 had only one attack while the third patient had two attacks. This indicates that there is more fibrinolytic activity when the number of attacks is increased. Other studies in fibrinolytic activity in Eales's disease has been reported in only very small series of patients. The various other series reported by other authors consists of 5 patients by Uemera and Akiya[5] Hagino[3] series of 8 patients and 5 patients of Paul and Adhlaka[4]. All have reported that fibrinolytic activity is raised in Eales's disease patients.

Besides the above observations that fibrinoly­tic activity is increased in Eales's disease patien­ts, we also observed that 37 cases of Eales's disease who had attacks of vitreous haemor­rhage showed more of fibrinolytic activity in comparison to 3 cases who had come to us in the stage where only venous dialatation and sheathing of the blood vessels were there without any attack of haemorrhage. Statistical analysis showed significant difference [Table - 7]

It was also noted in our study that fibrinolytic activity was much raised in 7 cases who had fresh attack of haemorrhage in comparison to 30 cases who had resolving haemorrhage [Table - 8] and further greater the number of attacks of fresh haemorrhage greater was the fibrinolytic activity [Table - 9]. Still it remains a dilemma whether this increase in fibrinolytic activity in Eales's disease is the primary factor at fault giving rise to haemor­rhage or due to certain other previous changes taking place in the body of Eales's disease cases causing liberation of certain toxins and histamine, which in their turn increase fibrino­lytic activity.

By this study it is shown that there is no doubt that fibrinolytic activity in these patients is definitely increased. More the attacks of haemorrhage more the increase in the activity. From this study we can conclude that fibrinolytic activity tests done regularly in Eales's disease patients may give us a warning of an impending attack of fresh haemorrhage for which the treatment can be started immediately.


  Summary Top


Fibrinolytic activity by euglobulin lysis and Fibrin plate lysis techniques was determined in 40 normal and cases 40 patients suffering from Eales's disease. It was observed that fibrinolytic activity is statistically significantly raised in Eales's disease patients-more the attacks of vitreous haemorrhage more it is raised.

 
  References Top

1.
Astrup T. and Mullertz, S., 1952, Arch. of Bioche­mistry, 40, 346.  Back to cited text no. 1
    
2.
Biggs and Macfarlane R.C., 1962„ Human Blood coagulation its disorders-3rd ed. Blackwell Scientific publication, Oxford, page 895, 96.  Back to cited text no. 2
    
3.
Hagino R., 1962, XIX International Congress Ophthal., 841.  Back to cited text no. 3
    
4.
Paul S.D. and Adlakha D.D., 1964, Ophthalmo­gica, 148, 374  Back to cited text no. 4
    
5.
Uemura M., Uemura and Akiya S., 1962, Amer. J. of Ophthal. 57, 67.  Back to cited text no. 5
    



 
 
    Tables

  [Table - 1], [Table - 2], [Table - 3], [Table - 4], [Table - 5], [Table - 6], [Table - 7], [Table - 8], [Table - 9]



 

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