|Year : 1983 | Volume
| Issue : 5 | Page : 592-593
Reduced fibrinolytic activity in aqueous humour in glaucoma
KS Mehra1, B Dube2, RK Dube2
1 Department of Ophthalmology, Institute of Medical Sciences, Banaras Hindu University, Varanasi-221 005, India
2 Department of Pathology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
K S Mehra
Department of Ophthalmology, Institute of Medical Sciences, Banaras Hindu University, Varanasi-221 005
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Mehra K S, Dube B, Dube R K. Reduced fibrinolytic activity in aqueous humour in glaucoma. Indian J Ophthalmol 1983;31:592-3
|How to cite this URL:|
Mehra K S, Dube B, Dube R K. Reduced fibrinolytic activity in aqueous humour in glaucoma. Indian J Ophthalmol [serial online] 1983 [cited 2020 Jan 21];31:592-3. Available from: http://www.ijo.in/text.asp?1983/31/5/592/36599
Kwaan et al  . reported presence of plasminogen activator in tissues at the angle of anterior chamber and canal of Schlemn. Pandolfi's  findings suggest that fibrinolysis could assist in preventing obstruction by fibrin of aqueous outflow pathways and could participate in regulation of outflow of aqueous humour. Perkins and Saiduzzaffar  have reported that plasmin, when placed in anterior chamber of monkeys, caused statistically significant increase in co-efficient of aqueous outflow. This present work highlights the remarkable reduction in fibrinolytic activity of aqueous humour in chronic simple glaucoma patients.
| Materials|| |
The patients under this study were divided into 2 groups: Group A of 6 patients, who were under going senile cataract surgery and Group B of another 6 patients with untreated chronic simple glaucoma. None of these 12 patients had any other local or systemic disease. Aqueous humour was obtained pre-operatively from both of these groups. The fluid was transported to the laboratory, cooled in an ice bucket and the tests for fibrinolytic activity were put up within half an hour of collection.
| Results|| |
The aqueous humour from all the 6 patients, with senile cataract, showed conspicuous lysis on human fibrin plate; the area of lysis ranged from 110 mm 2 to 900 mm 2 with an average of 423 mm2. In contrast the aqueous from as many as 5 out of 6 glaucoma patients showed complete absence of lysis on human fibrin plate; the remaining one case showed a small lysis of 42 mm 2 . Mean Whitney test showed a significant difference at 1% level. [Table - 1].
None of the samples from either group showed lysis on bovine fibrin plate. On adding streptokinase to aqueous, 5 out of 6 samples from cataract group showed lysis on bovine fibrin plate (mean: 49.5 mm 2 ). Similar streptokinase + aqueous mixture in glaucoma group showed lysis on bovine fibrin plate in 3 out of 6 samples (mean: 24.0 mm 2 ) Mean Whitney test showed a significant difference at 1°% level. [Table - 1].
| Discussion|| |
Our result show that there is conspicuous presence of plasminogen activator activity in human aqueous humour from cataract patients as also reported by Saiduzzaffar.  Absence of lysis on bovine fibrin plate probably implies absence of pro-activator in aqueous humour. Small amount of plasminogen appears to be present in majority of these patients, as inferred from aqueous + streptokinase experiment, but is significantly less in aqueous of glaucoma patients in comparison to normal group. [Table - 1].
It is obvious that there is marked depression of plasminogen activator activity in aqueous in glaucoma patients and its etiopathogenic implication in such patients appears significant. It is likely that depressed fibrinolysis predisposes to fibrin deposition in the angle of anterior chamber, which increase the resistence to aqueous outflow and thus results in increased intraocular tension.
It is interesting to note that eyes having chronic simple glaucoma are more prone to develop thrombosis of central retinal veins.
This association may be due to the depressed plasminogen activator activity in the blood and aqueous of this group of patients. An investigation on systemic fibrinolysis in glaucoma patients is under study. The therapeutic approach of enhancing fibrinolytic activity in chronic simple glaucoma patients may prove rewarding.
| Summary|| |
Fibrinolytic activity of aqueous humour was tested by Astrup fibrin plate lysis in 6 patients who had chronic simple glaucoma and was compared with a control group of 6 patients with senile cataract. The plasminogen activator content of aqueous humour in glaucoma patients was remarkably reduced; it was not demonstrable in as many as five out of six patients. The lysis zones in control group ranged from 110 to 900 mm' with an average of 423 mm 2 . The want of aqueous fibrinolytic activity may have a pathogenetic implication for glaucoma since deposition of ti brin in the angle of eye due to depressed fibrinolytic activity could well increase resistance to aqueous flow.
| References|| |
Kwaan, H.C., Astrup, T., Arch. Path., 76: 595,1963.
Pandolfi, M., Kwaan, H., Arch. Ophthal., 77: 99, 1967.
Perkins, E.S., Saiduzzaffar, H., Exp. Eye Research, 8: 386, 1969.
Saiduzzafar, H., Expt. Eye Research, 10: 293, 1970.
[Table - 1]