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Massive subhyaloidal hemorrhage associated with severe PAI-1 deficiency

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Abstract

Purpose

To report an association between spontaneous subhyaloidal hemorrhage and severe plasminogen activator inhibitor-1 (PAI-1) deficiency.

Methods

Case report.

Results

A 29-year-old woman presented with sudden, painless visual loss to hand motion in her right eye. Ophthalmoscopy showed a massive subhyaloidal hemorrhage. The patients' medical history was negative for cardiovascular risk factors, trauma, infections or bleeding complications. Further investigation into possible causes revealed hyperfibrinolysis secondary to severe PAI-1 deficiency. The non-clearing subhyaloidal hemorrhage was successfully treated by pars plana vitrectomy, and her visual acuity improved to 20/20.

Conclusion

When ordering laboratory tests in patients with spontaneous subhyaloidal hemorrhage to rule out fibrinolytic disorders, severe PAI-1 deficiency should be considered in the differential diagnosis. Selective screening may be helpful in identifying ophthalmologic patients with hyperfibrinolysis, especially in young individuals with subhyaloidal hemorrhages in the absence of other recognized risk factors.

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Authors and Affiliations

  1. Department of Ophthalmology, Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt am Main, Germany

    Claudia Kuhli, Marc Lüchtenberg & Lars-Olof Hattenbach

  2. Department of Internal Medicine, Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt am Main, Germany

    Inge Scharrer

  3. Klinik für Augenheilkunde, Klinikum der Johann Wolfgang Goethe-Universität, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany

    Claudia Kuhli

Authors
  1. Claudia Kuhli
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  2. Marc Lüchtenberg
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  3. Inge Scharrer
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  4. Lars-Olof Hattenbach
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Corresponding author

Correspondence to Claudia Kuhli.

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Kuhli, C., Lüchtenberg, M., Scharrer, I. et al. Massive subhyaloidal hemorrhage associated with severe PAI-1 deficiency. Graefe's Arch Clin Exp Ophthalmo 243, 963–966 (2005). https://doi.org/10.1007/s00417-005-0048-x

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  • DOI: https://doi.org/10.1007/s00417-005-0048-x

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