[Skip to Content]
[Skip to Content Landing]
Article
May 1991

Fibrin Directs Early Retinal Damage After Experimental Subretinal Hemorrhage

Author Affiliations

From the Department of Ophthalmology, School of Medicine, University of California, Davis, Sacramento.

Arch Ophthalmol. 1991;109(5):723-729. doi:10.1001/archopht.1991.01080050139046
Abstract

• Subretinal blood within the macula may cause visual loss in a number of macular diseases. The clinical and histopathologic effects of experimental subretinal hemorrhage were evaluated in the cat. Subretinal hemorrhages were produced by creating a focal neurosensory retinal detachment with micropipette techniques, then inserting a needle tip transsclerally to allow choroidal blood to fill the bleb. Experimental lesions were examined clinically and with light and electron microscopy during a 14-day postoperative period. Initial observations included clot organization with retraction of fibrin strands. In six of nine clots more than 1 hour old, fibrin was associated with tearing of sheets of photoreceptor inner and outer segments. Later degeneration progressed to involve all retinal layers overlying the densest areas of fibrin in the clots. Hemorrhages into subretinal blebs containing tissue plasminogen activator did not form fibrin strands or cause photoreceptor tearing. These findings highlight the potential for improved retinal survival if organized subretinal clot can be eliminated soon after formation.

References
1.
National Society for the Prevention of Blindness. Estimated Statistics on Blindness and Visual Problems . New York, NY: National Society for the Prevention of Blindness; 1966:44.
2.
Luxenberg MN.  Early surgical drainage of macular subretinal hemorrhage . Arch Ophthalmol . 1987;105:1722-1723.Article
3.
De Juan E, Machemer R.  Vitreous surgery for hemorrhagic and fibrous complications of age-related macular degeneration . Am J Ophthalmol . 1988;105:25-29.
4.
Bennett SR, Folk JC, Blodi CF, Klugman M.  Factors prognostic of visual outcome in patients with subretinal hemorrhage . Am J Ophthalmol . 1990;109:33-37.
5.
Wade EC, Flynn HW Jr, Olsen KR, Blumenkranz MS, Nicholson DH.  Subretinal hemorrhage management by pars plana vitrectomy and internal drainage . Arch Ophthalmol . 1990;108:973-978.Article
6.
Ryan SJ, Mittl RN, Maumenee AE.  The disciform response: an historical perspective . Graefes Arch Clin Exp Ophthalmol . 1980;215:1-20.Article
7.
Koshibu A.  Ultrastructural studies on absorption of experimentally produced subretinal hemorrhage, I: erythrophagocytosis at the early stage . Nippon Ganka Gakkai Zasshi . 1978;82:428-441.
8.
Koshibu A.  Ultrastructural studies on absorption of experimentally produced subretinal hemorrhage, II: autolysis of macrophages and disappearance of erythrocytes from the subretinal space at the late stage . Nippon Ganka Gakkai Zasshi . 1978;82:471-479.
9.
Koshibu A.  Ultrastructural studies on absorption of experimentally produced subretinal hemorrhage, III: absorption of erythrocyte breakdown products and retinal hemosiderosis at the late stage . Nippon Ganka Gakkai Zasshi . 1979;83:386-400.
10.
Glatt H, Machemer R.  Experimental subretinal hemorrhage in rabbits . Am J Ophthalmol . 1982;94:762-773.Article
11.
Ryan SJ.  The development of an experimental model of subretinal neovascularization in disciform macular degeneration . Trans Am Ophthalmol Soc . 1979;77:707-745.
12.
Doolittle RF.  Fibrinogen and fibrin . Sci Am . 1981;245:126.Article
13.
Immel J, Negi A, Marmor MF.  Acute changes in RPE apical morphology after retinal detachment in rabbit . Invest Ophthalmol Vis Sci . 1986;27:1770-1776.
14.
Anderson DH, Stern WH, Fisher SK, Erickson PA, Borgula GA.  Retinal detachment in the cat: the pigment epithelial-photoreceptor interface . Invest Ophthalmol Vis Sci . 1983;24:906-926.
15.
Anderson DH, Guerin CJ, Erickson PA, Stern WH, Fisher SK.  Morphological recovery in the reattached retina . Invest Ophthalmol Vis Sci . 1986;2:168-183.
16.
Johnson NF, Foulds WS.  Observations on the retinal pigment epithelium and retinal macrophages in experimental retinal detachments . Br J Ophthalmol . 1977;61:564-572.Article
17.
Marmor MF, Porteus M, Negi A, Immel J.  Validation of a model of non-rhegmatogenous retinal detachment . Curr Eye Res . 1984;3:515-518.Article
×