Components of the fibrinolytic system in the vitreous body in patients with vitreoretinal disorders.

PURPOSE: To assess components of the fibrinolytic system in the vitreous humour and serum of patients with vitreoretinal disorders.

METHODS

Forty-three samples of vitreous humour and plasma of 43 patients undergoing pars plana vitrectomy for macular hole, macular pucker, retinal detachment or proliferative vitreoretinopathy were evaluated for their content of plasminogen, a2-antiplasmin, plasminogen-activatorinhibitor 1, plasmin-a2-antiplasmin-complex, tissue plasminogen activator, total protein, albumin, d-dimer. Patient groups were compared with each other using the U-test (Mann and Whitney) for non-parametric testing of two independent samples.

RESULTS

The groups of retinal detachment and proliferative vitreoretinopathy had elevated vitreal levels of plasminogenactivator-inhibitor 1 (352.5 and 370.7 ng/mL vs. 1.86 and 56.6 ng/mL, P = non-significant), plasmin-a2-antiplasmincomplex (2416.5 and 1836.2 microg/L vs. 124.2 and 133.4 microg/L, P < 0.001), albumin (0.08 and 0.15 g/dL vs. 0.03 and 0.07 g/dL, P < 0.05) and d-dimer (4.76 and 1.64 microg/mL vs. 0.40 and 0.48 microg/mL, P = non-significant) when compared with patients with macular hole and macular pucker.

CONCLUSIONS

There are significant differences in the vitreal concentration of components of the fibrinolytic system in patients with vitreoretinal disorders. Breakdown of the blood-retinal barrier and complex disease-specific mechanisms are thought to be responsible for an increase of components of the fibrinolytic system in the vitreous.