a Department of Hematology , Istanbul Bilim University Medical School , Istanbul , Turkey.
b Department of Ophthalmology , Koç University Medical School , Istanbul , Turkey.
Curr Eye Res. 2019 Apr;44(4):406-412. doi: 10.1080/02713683.2018.1554152. Epub 2018 Dec 12.
To evaluate clotting dynamics by a new tool called rotational tromboelastometry (ROTEM) in retinal vein occlusion.
Thirty-six patients who were diagnosed with retinal vein occlusion and 43 age and sex matched healthy controls were included in this study. Diabetes and use of anticoagulant therapy were exclusion criteria. All study participants underwent detailed ophthalmologic and systemic medical examination, including blood pressure measurement, hemoglobin-hematocrit levels, platelet count, coagulation parameters including prothrombin time, activated partial thromboplastin time, fibrinogen levels, and D-dimer levels. Peripheral blood samples were collected and analyzed with ROTEM Coagulation Analyzer (Tem International, Munich, Germany).
The RVO patients and controls did not differ with respect to age, sex, hemoglobin, hematocrit, platelet numbers, prothrombin time, activated partial thromboplastin time, fibrinogen levels, D-dimer levels, and glucose levels. When extrinsic thromboelastometry results were analyzed, RVO patients showed a significantly decreased clotting time (76.5 ± 15.0 vs. 95.0 ± 21 s, respectively; p = 0.01) and clot formation time (83.3 ± 22 vs. 99.7 ± 24s; p = 0.01) as compared with healthy controls. Other ROTEM parameters did now show any difference between two groups.
Patients with retinal vein occlusion showed faster clotting time and shorter clotting formation time as compared with healthy controls. ROTEM detects the altered clotting dynamics and may be a useful tool to elucidate the disease pathophysiology. Further studies are needed to investigate if it can be used as a screening test for individuals who are under risk to develop RVO or as a first step test to evaluate hypercoagulable state in RVO.
通过一种名为旋转血栓弹性测定法（ROTEM）的新工具评估视网膜静脉阻塞的凝血动力学。
本研究纳入了 36 名被诊断为视网膜静脉阻塞的患者和 43 名年龄和性别匹配的健康对照者。患有糖尿病和正在使用抗凝治疗的患者被排除在外。所有研究参与者均接受了详细的眼科和全身医学检查，包括血压测量、血红蛋白-血细胞比容水平、血小板计数、凝血参数，包括凝血酶原时间、活化部分凝血活酶时间、纤维蛋白原水平和 D-二聚体水平。采集外周血样并使用 ROTEM 凝血分析仪（德国慕尼黑 Tem International 公司）进行分析。
视网膜静脉阻塞患者和对照组在年龄、性别、血红蛋白、血细胞比容、血小板计数、凝血酶原时间、活化部分凝血活酶时间、纤维蛋白原水平、D-二聚体水平和血糖水平方面无差异。当分析外在血栓弹性测定结果时，视网膜静脉阻塞患者的凝血时间（分别为 76.5±15.0 和 95.0±21.0 s；p=0.01）和凝块形成时间（分别为 83.3±22.0 和 99.7±24.0 s；p=0.01）明显缩短。两组之间的其他 ROTEM 参数没有差异。
与健康对照组相比，视网膜静脉阻塞患者的凝血时间更快，凝块形成时间更短。ROTEM 可检测到凝血动力学的改变，可能是阐明疾病病理生理学的有用工具。需要进一步研究以确定其是否可用于筛查易发生视网膜静脉阻塞的个体，或作为评估视网膜静脉阻塞患者高凝状态的初步检查。
