title: High subretinal fluid procoagulant activity in rhegmatogenous retinal detachment.
abstract: OBJECTIVE
  An increased mRNA expression of genes related to blood coagulation has been demonstrated in an experimental retinal detachment model but has not yet been confirmed in human clinical specimens. Tissue factor (TF), the initiating factor of blood coagulation, may be a determinant of the extent of tissue injury after rhegmatogenous retinal detachment (RRD). This study was conducted to determine whether subretinal fluid and vitreous fluid collected from patients with RRD have a procoagulant effect.
  
  
  METHODS
  Calibrated thrombin generation (CAT) was used to investigate the thrombogenic properties of 28 subretinal fluids collected during scleral buckling surgery for RRD. Further, the thrombogenic properties of vitreous fluids from RRD (n = 12), macular pucker (n = 5), macular hole (n = 6), and proliferative diabetic retinopathy (n = 5) were compared with the properties of eye bank eyes (n = 11), which served as control specimens. The procoagulant activity of TF was determined with Western blot analysis.
  
  
  RESULTS
  The addition of subretinal fluid from all RRD patients (28/28, 100%) induced thrombin generation in normal and severely factor (F)XII-deficient plasma. Contrary to the subretinal fluid, the addition of vitreous fluids from various ocular disorders evoked very little thrombin generation in normal and severely FXII-deficient plasma (4/12, 33% RRD; 1/5, 20% macular pucker; 0/6, 0% macular hole; 0/5, 0% proliferative diabetic retinopathy; and 2/11, 18% eye bank eyes). The procoagulant activity in subretinal fluid was almost completely neutralized by antibodies against human TF. The presence of TF in subretinal fluid was confirmed by Western blot.
  
  
  CONCLUSIONS
  Subretinal fluid of patients with RRD induces high procoagulant activity, determined by measuring the level of tissue factor.
authors.affiliation: Eye Research Institute Maastricht, Department of Ophthalmology, University Hospital Maastricht, Maastricht, The Netherlands. l.ricker@np.unimaas.nl
authors.forename: Lukas J A G
authors.initials: LJ
authors.lastname: Ricker
authors.forename: Raed Al
authors.initials: RA
authors.lastname: Dieri
authors.forename: Gerold J M
authors.initials: GJ
authors.lastname: Beckers
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Pels
authors.forename: Albert T A
authors.initials: AT
authors.lastname: Liem
authors.forename: Fred
authors.initials: F
authors.lastname: Hendrikse
authors.forename: Aize
authors.initials: A
authors.lastname: Kijlstra
authors.forename: H Coenraad
authors.initials: HC
authors.lastname: Hemker
authors.forename: Ellen C
authors.initials: EC
authors.lastname: La Heij
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015153:Blotting, Western; D001826:Body Fluids / Q000378:metabolism*; D003930:Diabetic Retinopathy / Q000378:metabolism; D005122:Exudates and Transudates / Q000378:metabolism; D005260:Female; D006801:Humans; D008268:Macular Degeneration / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D012163:Retinal Detachment / Q000378:metabolism* / Q000601:surgery; D012167:Retinal Perforations / Q000378:metabolism; D012591:Scleral Buckling; D013917:Thrombin / Q000032:analysis; D013925:Thromboplastin / Q000378:metabolism*; D014822:Vitreous Body / Q000378:metabolism; D055815:Young Adult
chemical_list: D013925:Thromboplastin; D013917:Thrombin