title: Vitrectomy for Proliferative Diabetic Retinopathy Associated with Klinefelter Syndrome.
abstract: BACKGROUND
  We encountered a patient with Klinefelter syndrome (KS) who experienced poor outcomes after vitrectomy for proliferative diabetic retinopathy (PDR).
  
  
  METHODS
  A 44-year-old male with poorly controlled diabetes was diagnosed with KS by chromosome analysis. Ocular findings revealed severe PDR complicated with extensive preretinal hemorrhages and traction retinal detachment in his left eye, and pars plana vitrectomy was subsequently performed for treatment.
  
  
  RESULTS
  A clotting hemorrhage developed during surgery and proved difficult to control. Due to postoperative bleeding and redetachment, the vitrectomy was repeated. At the second operation, we performed a silicone oil tamponade; however, the retina was redetached under the silicone oil, and the light perception vision ultimately disappeared.
  
  
  CONCLUSIONS
  The patient, despite showing increased blood coagulability due to diabetes, presented severe coagulopathy, likely related to KS. In patients with KS and severe PDR, the potential difficulty of vitrectomy should always be kept in mind.
authors.affiliation: Department of Ophthalmology, Osaka Medical College, Takatsuki, Osaka, Japan.
authors.forename: Kensuke
authors.initials: K
authors.lastname: Tajiri
authors.affiliation: Department of Ophthalmology, Osaka Medical College, Takatsuki, Osaka, Japan.
authors.forename: Kohei
authors.initials: K
authors.lastname: Otsuki
authors.affiliation: Department of Ophthalmology, Osaka Medical College, Takatsuki, Osaka, Japan.
authors.forename: Takaki
authors.initials: T
authors.lastname: Sato
authors.affiliation: Department of Ophthalmology, Osaka Medical College, Takatsuki, Osaka, Japan.
authors.forename: Daisaku
authors.initials: D
authors.lastname: Kimura
authors.affiliation: Department of Ophthalmology, Osaka Medical College, Takatsuki, Osaka, Japan.
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Kobayashi
authors.affiliation: Department of Ophthalmology, Osaka Medical College, Takatsuki, Osaka, Japan.
authors.forename: Teruyo
authors.initials: T
authors.lastname: Kida
authors.affiliation: Department of Ophthalmology, Osaka Medical College, Takatsuki, Osaka, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Sugasawa
authors.affiliation: Department of Ophthalmology, Osaka Medical College, Takatsuki, Osaka, Japan.
authors.forename: Tsunehiko
authors.initials: T
authors.lastname: Ikeda
keywords: Blood coagulopathy; Diabetic retinopathy; Klinefelter syndrome; Vitrectomy