Florid diabetic retinopathy (FDR): a long-term follow-up study

Lattanzio, Rosangela; Brancato, Rosario; Bandello, Francesco; Azzolini, Claudio; Malegori, Angela; Maestranzi, Gisella

doi:10.1007/s004170100261

Cited by 19 publications

(9 citation statements)

References 11 publications

(20 reference statements)

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“…Although improving, the prognosis remains worrying. Treatment is by aggressive panretinal photocoagulation (PRP), if necessary, associated with early surgery [45].…”

Section: Florid Pdrmentioning

confidence: 99%

Diabetic retinopathy

2002

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Abstract. Easy observation of the fundus oculi makes retinopathy the most frequently reported chronic complication of diabetes and, consequently, the one we know best in terms of epidemiology and natural history. Achieving near-normal levels of blood glucose and blood pressure provides empirical though powerful tools for clinicians to delay the onset and progression of diabetic retinopathy. Even when these measures have failed and retinopathy becomes sight-threatening, laser photocoagulation has proven remarkably effective. Nonetheless, retinopathy remains a leading cause of blindness and there is little evidence that diabetes-related visual loss is decreasing in industrialized countries. This may result from the mixed blessing of prolonged survival of patients who had become diabetic when metabolic control was pursued less fastidiously than today. Screening for sight-threatening retinopathy is the most cost-effective medical procedure known and should help optimise the use of diagnostic and therapeutic resources, but its widest deployment still meets with inertia and lack of interest within most health care systems. Improving clinical skills and technology, however, allow us to take a more optimistic look at the future, as pathogenesis-targeted forms of treatment are being developed and tested through appropriately powered clinical trials. [Diabetologia (2002[Diabetologia ( ) 45:1617[Diabetologia ( -1634

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“…Although improving, the prognosis remains worrying. Treatment is by aggressive panretinal photocoagulation (PRP), if necessary, associated with early surgery [45].…”

Section: Florid Pdrmentioning

confidence: 99%

Diabetic retinopathy

2002

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“…Seventy-five per cent of the cases that receive early treatment show regression of NV whereas late treatment has been associated with a six times higher risk of blindness. 1 In our case, the FFA was performed at ten days and the laser treatment at two weeks after presentation representing relatively early diagnosis and treatment. Even during that period, the extent of vitreous haemorrhage became significantly larger (Figures 2 and 3a).…”

Section: Discussionmentioning

confidence: 87%

“…The rapidly progressing bilateral PDR in young patients with poorly controlled diabetes has been described as FDR. 1 It is more common in females (66%) and has a devastating course. The pathophysiology of the disease has been postulated to be acute retinal ischaemia.…”

Section: Discussionmentioning

confidence: 99%

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Acute ischaemia triggers florid diabetic retinopathy in a 51-year-old woman

Antonopoulou

Styles

2013

Diabetes & Vascular Disease

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“…The wolf’s jaw configuration of a perimacular ring of fibrovascular preretinal tissue [ 14 , 35 ] was more frequent in type 1 DM with florid DR, which needed surgical intervention [ 2 , 36 ]. NIR imaging showed the neovascularization as hyporeflective fronds and the fibrosis as hyperreflective tissue [ 25 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

Near-infrared reflectance imaging of neovascularization in proliferative diabetic retinopathy

2020

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Background Blood is one of the main absorbers in the near-infrared spectrum and thus retinal vessels appear dark in near-infrared reflectance (NIR) images. Proliferative diabetic retinopathy (PDR) is characterized by abnormal neovascularization which also absorbs light and appears dark against a lighter fundus background. We analyzed neovascularization in PDR using NIR imaging, by observing changes in the neovascular complexes (NVCs) contrast and reflectivity over time. Methods Retrospective case series of 20 eyes of 17 patients with PDR who underwent NIR imaging with optical coherence tomography (OCT) using the Spectralis System. NVCs presence and activity was determined using clinical, tomographic and angiographic criteria. At baseline, all NVCs were qualitatively graded in the NIR image into 3 groups (absent, present and inactive and present and active) and their evolution over time was registered as progression, regression or same status. Results Twenty-seven NVCs were imaged, of which, 52% were neovascularization of the disc (NVD) and 48% were elsewhere (NVE). Consecutive NIR images were obtained from baseline to up to 5 time-points with a mean follow-up of 3.2 ± 1.7 years. All eyes underwent laser treatment and 30% had additional intravitreal therapy. Using NIR imaging, NVCs were classified at baseline as absent, present and inactive and present and active, respectively in 11, 4 and 85% of cases. NIR identified active neovascularization as hyporeflective irregular dark vessels originating from the retinal venules in NVE or from the disc in NVD. In all groups during follow-up, progression was identified as the development of new vascular hyporeflective dark fronds while regression was shown by reduced dark perfusion. Five eyes developed a wolf’s jaw configuration with vascular hyporeflective new vessels and hyperreflective tissue from extensive fibrosis. Fibrosis was more apparent in later images, reaching 86%. In 3 cases (11%), the NVC was no longer seen in NIR, although was still identifiable on OCT over the NVC area. Conclusions NIR is a non-invasive imaging modality commonly performed alongside OCT and frequently overlooked which can be useful to evaluate NVCs in PDR. Changes in NVC contrast and reflectivity due to blood perfusion can help in the detection and monitoring of diabetic proliferative disease and aid clinicians in daily practice.

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Florid diabetic retinopathy (FDR): a long-term follow-up study

Cited by 19 publications

References 11 publications

Diabetic retinopathy

Diabetic retinopathy

Acute ischaemia triggers florid diabetic retinopathy in a 51-year-old woman

Near-infrared reflectance imaging of neovascularization in proliferative diabetic retinopathy

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