[Thrombin-antithrombin III complexes in plasma and subretinal fluid in patients with perforated retinal detachment]

To study the thrombin generation in plasma and subretinal fluid (SRF) by evaluation of thrombin-antithrombin III complexes (TAT) and antithrombin III (AT III) activity in patients with rhegmatogenous retinal detachment.

Prospective study of 54 patients subjected to retinal detachment surgery. Patients with vein or arterial disease and with other factors which could change evaluated parameters were excluded. Subretinal fluid samples were obtained at the time of routine drainage during retinal detachment surgery. Venous blood samples were taken from the cubital vein to natrium citrate solution (9:1) immediately after induction of anaesthesia but before surgery. TAT concentration in citrate plasma and in SRF was assessed in 22 patients aged from 15 to 78 years (mean: 49.5 years). AT III activity in blood plasma and SRF was measured in 32 patients aged from 20 to 77 years (mean: 53.8). The correlations between the TAT concentration in SRF were evaluated as well as AT III activity in SRF, and age, sex of patients, the duration and extent of retinal detachment, number of retinal tears and the cryopexy application.

The median value of TAT concentration in citrate plasma was 9.08 micrograms/l (interquartile range: 59.3 micrograms/l). In 20 cases out of 22 eyes studied TAT levels were higher than 60 micrograms/l. The mean level of AT III activity in blood plasma was 105% (SD: 24.0%). The median level of AT III activity in 32 samples of SRF was 16.5% (interquartile range: 14.5%). The levels of AT III in SRF were significantly lower than AT III values in blood plasma (p < 0.001). We found no correlation between the levels of AT III activity in plasma and AT III activity in SRF nor between TAT concentration, AT III activity in SRF and sex, age of patients, the degree of myopia, the duration and extent of retinal detachment, nor retinal degenerative changes and cryopexy application.

Our study revealed high TAT concentration and AT III activity and in all studied samples of SRF disclosing the signs of thrombin generation in SRF.