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October 1981

Hemorrhages in Ophthalmology: A Hemostatic Approach

Arch Ophthalmol. 1981;99(10):1871. doi:10.1001/archopht.1981.03930020745027

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This is a good book that deserves to be read by clinicians and investigators alike. Some of the questions it raises include the following: Why are some hyphemas clotted and others liquid? Why are intravitreous hemorrhages usually solid, whereas retrovitreous blood is generally dispersed? Why do intraretinal hemorrhages tend to remain circumscribed? Why does blood liberated during a cataract operation clot quickly in the collapsed anterior chamber? When should ophthalmologists consider therapeutic agents that promote clot formation as opposed to those that foster clot lysis? For example, when should aminocaproic acid be used on the one hand and urokinase on the other? How does the clinician recognize a potential bleeder preoperatively?

Pandolfi emphasized that the retina has the highest thromboplastic activity of all the tissues of the body, whereas the choroid has the highest fibrinolytic activity. How do these opposing tendencies influence hemorrhagic macular degeneration that occurs between these two

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