Retinopathia Diabetica Proliferans

Abstract

BY Tore KorneruiiRetinopathy diabetica proliferans (rdp) is a type of retinopathy found in diabetics, characterized by proliferating connective tissue and newly formed vessels invading the ocular fundus. These vessels rupture easily causing haemorrhages into the vitreous. In cases where vitreous haemorrhages have made inspection of the fundus impossible a diagnosis of rdp is made. Connective tissue proliferation invading the fundus is found in several diseases and lesions, where retinal haemorrhages is the presenting sign. In diabetes, however, the proliferation may be the presenting sign (5, 29, 58).Ballantyne ( 5 ) discerns five types of diabetic retinopathy (rp). Of these the types 111, IV and V fall within the definition of rdp given above. Type I11 is characterized by venous changes, >>phlebosclerosisqc, and by newly formed vessels situated intra-and preretinally. Retinal haemorrhages are often seen in this type. In some places the veins, which are dilated and tortuous come near the retinal surface. Where this happens the membrana limitans interna is absent and the vessels become starting points for pre-retinal retia mirabilia and for vascular tufts growing into the vitreous.The types IV and V are more advanced forms of rdp. In everyone of these types primary connective tissue proliferations may occur. They grow out from the disc as thin webs in which delicate newly formed vessels are seen. When these rupture, they give rise to subhyaloid haemorrhages, sometimes invading the vitreous. At times the vascular proliferations dominate the fundus picture to such an extent that the term ,rubeosis retinae<< can be applied (56). T h e secondary proliferations occur when the haemorrhages are organized and replaced by fibrin and connective tissue. Some authors think (17, 20) that, as a rule, rdp starts with vitreous haemorrhages and that the formation of connective tissue and the appearance of new vessels are secondary phenomena.") Received Dec. 2nd 1957.

Impaired Retinal Vasoreactivity: An Early Marker of Stroke Risk in Diabetes

“…This finding is in line with fundoscopy‐based studies suggesting involvement of the retinal venous rather than the arterial microcirculation in early stages of diabetic retinopathy . Previous studies have described retinal venous stasis and enlargement of retinal veins as one of the earliest and sometimes only finding in diabetic retinopathy, found in about 10% to 43% of patients with type 1 or type 2 diabetes . These venous changes can be associated with increased vascular permeability and impaired endothelial integrity of the microvasculature, and result in lower AVRs in diabetics compared to healthy individuals …”

The Prevalence of Retinopathy in Insulin‐dependent Juvenile‐onset Diabetes Mellitus ‐a Fluorescein‐angiographic Study

“…Proliferative retinopathy was present in 18% of the case material. Such retinopathy was observed in 3.8% of 1000 consecutively examined patients in a large diabetic clinic in England (Scobie 1981), in 8.4% of 1402 non-selected diabetics examined by ophthalmoscopy in Stockholm (Kornerup 1958) and in 5.7% in the population study from Iceland (Danielsen 1982). Palmberg (1981) and Lestradet (1981) give no prevalence rates for their whole case materials, but the prevalence rises to 26% and 18%, respectively, after 26 years of diabetes.…”

Stratifying Renal Risk and Retinal Involvement in South Indian Type 2 Diabetic Patients: Using the Kdigo Classification

“…The prevalence of DR among diabetic population in rural South India was 10.5% [13] and urban Chennai was 17.6% [14]. Earlier studies showed high prevalence of proteinuria among patients with proliferative retinopathy [15] and further it was also reported that DR is more severe in patients with severe DN. Overt albuminuria in the T2DM appears to be a powerful predictor of DR [16].…”