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Bilateral retinal vasculitis associated with clotting disorders

H Savir, T Wender, D Creter

    American Journal of Ophthalmology
    |October 1, 1977
    PubMed
    Summary

    Distinct clotting and fibrinolytic alterations were observed in a patient with bilateral vasculitis affecting central retinal veins. These changes, including low plasminogen and absent kallikrein, were also noted in his family members.

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    Area of Science:

    • * Hematology
    • * Ophthalmology
    • * Vascular Biology

    Background:

    • * Central retinal vein obstruction can be associated with systemic hemostatic abnormalities.
    • * Vasculitis is an inflammatory condition affecting blood vessels, potentially impacting ocular circulation.

    Observation:

    • * A 27-year-old male presented with bilateral central retinal vein obstruction secondary to vasculitis.
    • * Clinical and fluoroangiographic findings indicated severe impairment of retinal blood flow.

    Findings:

    • * The patient exhibited altered clotting and fibrinolytic mechanisms, including increased partial thromboplastin time and partial clot lysis.
    • * Markedly low plasminogen levels, decreased alpha2-macroglobulin, factor XII, and IgG were observed.
    • * Kallikrein was notably absent in the patient's blood.

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  • * Similar, though less severe, hemostatic changes were present in the patient's son and brother, suggesting a potential hereditary component.

    • Implications:

    • * These findings suggest a potential link between specific hemostatic factor deficiencies and the development of retinal vasculitis and vein obstruction.
    • * The familial occurrence of these alterations highlights the possibility of a genetic predisposition.
    • * Further research into these specific clotting and fibrinolytic abnormalities may reveal novel diagnostic markers or therapeutic targets for retinal vascular diseases.