Skip to main content

ORIGINAL RESEARCH article

Front. Med.
Sec. Ophthalmology
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1372831

Case Reports: Intraoperative Migratory Retinal Venous Thrombus in Proliferative Diabetic Retinopathy

Provisionally accepted
Danni Lyu Danni Lyu 1Huan Liu Huan Liu 2Yijiong Fang Yijiong Fang 3Yao Wang Yao Wang 1*
  • 1 Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
  • 2 The First People’s Hospital of Hangzhou Linan District, Hangzhou, Jiangsu Province, China
  • 3 Department of Ophthalmology, The First people's Hospital of Xiaoshan District, Hangzhou, China

The final, formatted version of the article will be published soon.

    To study the characteristics, possible cause, and clinical implication of intraoperative migratory retinal venous thrombus in proliferative diabetic retinopathy (PDR). Cases: Two middle-aged Chinese patients with diabetes mellitus presented with blurred vision and were diagnosed with PDR and tractional retinal detachment (TRD). An interesting phenomenon was observed during pars plana vitrectomy in both patients. Movement of tiny white thrombi and interruption of blood flow were observed in a branch of the central retinal vein when the vein was pulled at the time of fibrovascular membrane delamination, and disappeared with elimination of retinal traction after finishing the process of delamination. Laboratory studies revealed abnormal erythrocyte sedimentation rate, fibrinogen, D-dimer, international normalized ratio, and IgA anti-β2-glycoprotein I in one patient, and elevated fibrinogen and IgA anticardiolipin in the other. Follow-up examinations at 1 week, 1, 3, and 6 months postoperatively showed good prognosis. Fluorescein fundus angiography at 1 month postoperatively showed neither embolus sign nor prolonged venous filling time in both patients. Discussion: Local blood stasis of the retinal vein persistently dragged by the fibrovascular membrane may result in thrombogenesis, and traction of retina during delamination process may lead to the movement of thrombi. On the other hand, endothelial injury and disordered local blood stasis during delamination may also activate the biological coagulation process and instant thrombus formation. As well, antiphospholipid antibodies may also be a risk factor of ocular thrombogenesis.This study provides the first videos recording migratory thrombus in terminal vessels, which indicates that fibrovascular membrane in PDR can lead to thrombogenesis due to dragging and hemostasis of the involved retinal vein. PDR patients with fibrovascular membranes may benefit from early relief of vascular traction through fibrovascular membrane delamination.

    Keywords: fibrovascular membranes delamination, migratory retinal venous thrombus, proliferative diabetic retinopathy, tractional retinal detachment, Vitrectomy

    Received: 18 Jan 2024; Accepted: 24 Jul 2024.

    Copyright: © 2024 Lyu, Liu, Fang and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Yao Wang, Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang Province, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.