|Year : 1977 | Volume
| Issue : 3 | Page : 9-11
Blood fibrinolysis in Eales's Disease (a followup study)
SD Pathak1, KS Mehra1, B Dube2
1 Department of Ophthalmology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
2 Department of Pathology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
K S Mehra
4 Medical enclave, Varanasi 221 005
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Pathak S D, Mehra K S, Dube B. Blood fibrinolysis in Eales's Disease (a followup study). Indian J Ophthalmol 1977;25:9-11
|How to cite this URL:|
Pathak S D, Mehra K S, Dube B. Blood fibrinolysis in Eales's Disease (a followup study). Indian J Ophthalmol [serial online] 1977 [cited 2020 Jun 5];25:9-11. Available from: http://www.ijo.in/text.asp?1977/25/3/9/31261
The authors report the result of blood fibrinolytic activity in follow up study of 8 cases of Eales's disease. In all the eight patients, who were followed up, after treatment with corticosteroid, there was inhibition of fibrinolytic activity-more the duration of the treatment lesser was the fibrinolytic activity at the time of fresh attack of vitreous haemorrhage. Thus it indicates that estimation of fibrinolytic activity in Eales's disease patients might herald the incoming fresh attack and it is also confirmed with this study that with corticosteroid treatment fibrinolytic activity is definitely reduced.
Aetiopathogenesis of Eales's disease still remains a problem. In our previous study we had reported that fibrinolytic activity:
(i) was raised in patients suffering from Eales's disease
(ii) More the number of attacks of vitreous haemorrhage greater was the fibrinolytic activity.
(iii) This was raised in patients having fresh attack in comparison to those who came in the resolving stage of vitreous haemorrhage.
(iv) Fibrinolytic activity was much raised in those, who had even a single attack of vitreous haemorrhage, in comparison to those who had no attack of vitreous haemorrhage and showed only sheathing and tortuosity of veins.
Literature is silent about the fact that whether after giving treatment in Eales's disease, is there any alteration in the fibrinolytic activity or not? So, with this thing in mind we took up the present study to find out the effect of treatment on the fibrinolytic activity in Eales's disease patients.
| Material and Method|| |
Eight cases have been taken for the present study. All the cases were males, whose age group ranged from 20-23 yrs., and had sudden loss of vision and diagnosis of the Eales's disease was made. Besides other investigations fibrinolytic activity was measured by Euglobulin lysis time test and Fibrin plate lysis method. Patients were kept under the following treatment:
1. A course of systemic Dexamethasone-given in divided doses for 40 days.
2. Retrobulbar injection of Dexamethasone 2 mg on alternate days-10 such injections.
3. Crooks collosal iodine one teaspoonful thrice a day.
On their subsequent visits the fibrinolytic acticity was again determined and also in the patients who attended with fresh attack of vitreous haemorrhage. The observations of these eight patients are shown in the Table.
1. Euglobulin lysis time-(determined by the technique of Buckell as described by Biggs and Macfarlane). more than three hours is considered as normal and less than this is considered as abnormal (raised fibrinolytic activity). The same finding as expressed in unit less than 55 is considered within normal range.
2. Lysis of Fibrin plate: (determined by technique of Astrup and Mullertz) Lysis from 10-100 mm is considered as normal and above 100 mm is considered as abnormal (raised).
| Observations|| |
It was observed that 4 patients, showed rise in Euglobulin lysis time as well as more of fibrin plate lysis time at the time of fresh attack of vitreous haemorrhage i.e. cases No. 1, 2, 3 and 5 while other 4 patients had no attack of fresh vitreous haemorrhage during the period of observation.
Further, it was observed that after giving the necessary treatment the fibrinolytic activity got reduced in these patients both by Euglobulin lysis time and Fibrin plate lysis as shown in all 8 cases.
| Discussion|| |
Eight patients were followed up in this study. The raised fibrinolytic activity in four cases, who had no fresh vitreous haemorrhage came down after treatment. In another four cases with the onset of fresh haemorrhage the fibrinolytic activity increased but after treatment it came down. The difference in fibrinolytic activity in patients with fresh haemorrhage and those with resolving haemorrhage was statistically significant when tested by fibrin plate lysis but the difference was not statistically significant, between these two groups when tested by Euglobulin lysis time. No satisfactory explanation can be forwarded for this paradox. In the present study the fibrinolysis ran parallel with the number of recurrences of vitreous and retinal haemorrhages. Though the treatment brought down the fibrinolytic activity it was not able to stop the recurrences.
Uemura and Akiya in their study of five cases have shown that steroid hormone inhibited the bleeding and decreased the plasmin activity. This was the basis of the belief of the authors that plasmin might have an important role in the several types of intra ocular haemorrhages. Hagino also reported increased fibrinolytic activity in Eales's disease and also reported that recurrence of the intraocular haemorrhage was followed by further increase in the activity.
According to Mikata et al fibrinolytic activity was decreased with administration of A.C.T.H. or steroids hormone and it was thought that these agents accelerate the binding action of plasmin and antiplasmin.
Our findings are more or less in conformity with the findings of the above authors with the distinction that our all the 4 cases showed raised fibrinolytic activity at the time of fresh attack and in all 8 cases after the treatment the fibrinolytic activity came to more or less normal level.
By this study it is shown that there is no doubt in the fact that fibrinolytic activity in these patients definitely gets increased. More the recurrences more is increase in the fibrinolytic activity and with corticosteroid treatment this activity gets diminished. We can conclude that Fibrinolytic activity tests done regularly in Eales's disease patients may give us a warning of the impending attack of fresh haemorrhage, for which the treatment can be started immediately.
| References|| |
Astrup T., Mullertz. S, 1952, Arch. of Biochemistry, 40,
Biggs and Macfarlane, R.C., 1962, Human blood coagulation, its disorders-3rd ed. Blackwell Scientific Publication Oxford page 895-96.
Hagino., R., 1962, XIX International Congress Ophthal.,
Mikata, I., et al,
1959, Keio. J. Med., 8,
Pathak S.D., Mehra K. S. and Dube B., Blood Fibrinolytic Studies in Eales's disease 1977, Ind.
Paul S.D. and Adlakha D.D., 1964, Amer. Jour. of Ophthal.. 57, 67.
Uemura M. Uenauray, Akija S, 1962-Awer. J. Opathal. 57, 67.
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