Identification of diagnostic and prognostic indicators of hypercoagulability in patients with pseudoexfoliation syndrome

Patients diagnosed with Pseudoexfoliation (PEX) syndrome are highly detected in the group of people over 50 years old. The risk of thrombotic incidents increases in the PEX patients due to the impact of abnormal intraocular vascular deposition. This study aims to clarify the fundamental mechanism of possible hypercoagulability state in the PEX patients leading to venous thrombosis and secondary disease in this study group. Eighteen ocular PEX syndrome cases (mean age 63.6 ± 6.5 years) attended as a study group and nineteen cases without PEX syndrome (mean age 69.7 ± 4.4 years) as a control group participated in this study. Blood samples were analyzed by ROTEM®, Complete Blood Count test and Flow cytometry. A one-tailed Mann-Whitney was performed for statistical assessment of the data presented in this study. The mean values of the ROTEM analysis were significantly decreased in the FIBTEM clotting time (CT) (60.3 vs 56.9; P <0.05) and increased FIBTEM alpha-angle (70.0 vs 73.3; P <0.05) when comparing the control group with PEX patients. In flow cytometric measurement, data showed a considerable difference in the expression level of CD62P (P < 0.0001) and PAC-1 (P <0.05) between the study groups. Antigen-binding capacity (ABC) analysis revealed Furthermore, a significant difference in the CD62p marker (P <0.05). Complete Blood Count parameters of the PEX group did not show any significant differences compared to the controls. The result from the study suggests the higher contribution of functional fibrinogen in clot formation and a high level of platelet activation markers that expressed in the PEX patients. These findings support the idea that PEX syndrome increase the chance of hypercoagulability in PEX patients. Further investigations are recommended to broaden our knowledge of the exact role of platelets and functional fibrinogen in the initiation or development of PEX syndrome. Keywords: Hypercoagulability, ROTEM, Pseudoexfoliation syndrome, Coagulation