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September 1973

Ocular Changes in the Generalized Shwartzman Reaction

Author Affiliations

San Francisco
From the University of California School of Medicine and San Francisco General Hospital, San Francisco.

Arch Ophthalmol. 1973;90(3):218-224. doi:10.1001/archopht.1973.01000050220007

Alterations in ocular vascular permeability in the generalized Shwartzman reaction were quantitated utilizing intravenously administered iodinated I 125 serum albumin, and histopathologic studies were made. Results were compared to changes in ocular blood vessels following a single injection of endotoxin, to histopathologic changes in the kidney, and to changes in animals anticoagulated with heparin sodium. The quantity of fibrin found in vessels of the ciliary processes was similar to that in the kidney, and an exhaustion of fibrinolytic mechanisms probably plays a role in persistence of thrombi. Damage to blood vessels of the iridial processes caused by fibrin thrombi could be prevented by heparin. A basic mechanism in the localization of occlusive fibrin thrombi in ocular vessels, and probably in vessels throughout the body, in the generalized Shwartzman reaction appears to be an alteration in blood flow.