Clinicopathologic Correlations in Diabetic Retinopathy

Bresnick, George H.; Davis, Matthew D.; Myers, Frank L.; Venecia, Guillermo de

doi:10.1001/archopht.1977.04450070113010

Cited by 85 publications

(14 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Comparative studies further elucidated that that 31.6% (IQR, 21.2%-52.0%) of the white dots corresponded to microaneurysms, which appeared as hyperfluorescent dots on the FA images, and most white dots around the boundary of nonperfused areas corresponded to microaneurysms (Fig 3). [19–21] The total number of white dots was correlated significantly with the number of white dots corresponding to microaneurysms on FA images ( ρ = 0.860, P <0.001) but not with the number of H/Ma on the SLO images ( ρ = 0.078, P = 0.505; Fig 4). We sometimes observed white dots with no definite findings on the FA or OCT images; these dots should be characterized in future studies.…”

Section: Resultsmentioning

confidence: 95%

“…Previous reports have described the various appearances of the microaneurysms, including whitish or reddish ones, which depended on the presence of red or white blood cells, the properties of the vascular walls, or the stages in fibrotic maturation. [19–21, 24] Further evaluation using adaptive optics imaging may elucidate the relationship between the microaneurysms of different colors and the flow of blood components. [25] In addition, most whitish microaneurysms were in the areas with low capillary density or around the boundary between the typical nonperfused areas and the typical perfused areas, which prompted us to speculate that these white dots may be developed during capillary dropout, because the disrupted flow of blood components, including erythrocytes, may affect the color of the microaneurysms.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

White Dots as a Novel Marker of Diabetic Retinopathy Severity in Ultrawide Field Imaging

et al. 2016

View full text Add to dashboard Cite

PurposeTo characterize white dots in diabetic retinopathy (DR) and their association with disease severity using ultra-wide-field scanning laser ophthalmoscopy.MethodsWe randomly selected 125 eyes of 77 patients (25 eyes from individual categories of the international classification of DR severity) for which ultrawide field photographs were obtained. We characterized white dots, which were delineated by higher signal levels on green but not red laser images, and evaluated the relationship between the number of white dots and the international severity scale of DR.ResultsMost white dots were located in nonperfused areas, and the number of total white dots was significantly correlated to that of dots in nonperfused areas. White dots corresponded to microaneurysms around the boundary between nonperfused areas and perfused areas or unknown lesions in nonperfused areas. Eyes with DR had significantly more white dots than those with no apparent retinopathy. The numbers of white dots in moderate nonproliferative diabetic retinopathy (NPDR) or more severe grades were significantly higher than in mild NPDR. The area under the receiver operating characteristics curve (AROC) analyses demonstrated that the number of white dots had the significance in the diagnosis of DR (0.908–0.986) and moderate NPDR or more severe grades (0.888–0.974).ConclusionsThese data suggest the clinical relevance of white dots seen on ultrawide field images in the diagnosis of the severity of DR.

show abstract

Section: Resultsmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

White Dots as a Novel Marker of Diabetic Retinopathy Severity in Ultrawide Field Imaging

et al. 2016

View full text Add to dashboard Cite

show abstract

“…3,4 Most knowledge regarding structure and localization of diabetic retinal microaneurysms is derived from histological and pathological studies. 5–10 These studies have shown that diabetic microaneurysms are incompetent vascular outpouchings of the macular capillary bed that primarily arise from the deep part of the inner retinal capillary plexus, 6, 7 and are located in the inner nuclear layer (INL) extending infrequently to the outer plexiform layer (OPL). 7,8 However, most histopathological studies have been based on trypsin digested retinal flat mounts with light microscopy or electron microscopy.…”

Section: Introductionmentioning

confidence: 99%

Characterization of Diabetic Microaneurysms by Simultaneous Fluorescein Angiography and Spectral-Domain Optical Coherence Tomography

Wang

Chhablani

Freeman

et al. 2012

American Journal of Ophthalmology

View full text Add to dashboard Cite

PURPOSE To correlate spectral domain optical coherence tomography (SD-OCT) findings of perfused diabetic microaneurysms with leakage status on fluorescein angiography (FA) using simultaneous FA and SD-OCT. DESIGN Retrospective, observational case series. METHODS 173 microaneurysms were analyzed in 50 eyes (14 mild nonproliferative diabetic retinopathy (NPDR); 22 moderate NPDR; 9 severe NPDR; 5 proliferative diabetic retinopathy (PDR)) of 40 diabetic patients using simultaneous FA and SD-OCT. The characteristics of microaneurysms were evaluated by two masked observers using SD-OCT and correlated with leakage status on FA. RESULTS External diameter of microaneurysms averaged 104 microns (range 43 – 266 microns). Some microaneurysm centers (15/173, 9%) and the outermost extent of microaneurysms (113/173, 68%) were localized to the outer half of the retina. Almost all microaneurysms spanned more than 1 retinal layer (157/173; 91%). Most microaneurysms had an internal lumen with homogeneous reflectivity (109/173; 63%) and moderate reflectivity (87/173; 50%). Both retinal thickness through microaneurysms as well as the presence of adjacent hypo-reflectivity on SD-OCT correlated with increasing leakage status seen on FA (P < 0.001). Microaneurysms’ dimensions, percent depth within the retina, retinal layer location, and internal reflectivity by SD-OCT did not correlate significantly with FA leakage status. CONCLUSIONS Simultaneous FA and SD-OCT allows detailed characterization of perfused diabetic microaneurysms. Increased FA leakage of diabetic microaneurysms positively correlated with peri-aneurysm fluid and retinal thickness. Perfused microaneurysms seen by SD-OCT were localized deeper than the inner nuclear layer.

show abstract

“…Underlying the complex clinical manifestations of diabetic retinopathy are two fundamental abnormalities: increased retinal vascular permeability and progressive retinal vessel closure (2, 3). Digested retinal vasculature preparations from diabetic patients and animals characteristically show early pericyte loss which is followed by acellular capillary development and microaneurysm formation (4,5). The severity of these changes is associated with the degree of chronic hyperglycemia to which the diabetic retina has been exposed, but the mechanisms by which elevated glucose levels cause retinal damage are currently not known (6, 7).…”

mentioning

confidence: 99%

Aminoguanidine treatment inhibits the development of experimental diabetic retinopathy.

Hammes

Martin

Federlin

et al. 1991

Proc. Natl. Acad. Sci. U.S.A.

470

266

View full text Add to dashboard Cite

Retinal capillary closure induced by hyperglycemia is the principal pathophysiologic abnormality underlying diabetic retinopathy, but the mechaniss by which this induction occurs are not clear. Treatment of diabetic rats for 26 weeks with aminouanidine, an inhibitor of advanced glycosylation product formation, prevented a 2.6-fold accumulation of these products at branching sites of precapillary arterioles where abnormal periodic acid/Schiff reagentpositive deposits also occurred. A dine treatment completely prevented abnormal endothelial cell proliferation and signiflcantiy diminshed pericyte dropout. After 75 weeks, untreated diabetic animals developed an 18.6-fold increase in the number of acellular capillaries and formed capillary microaneurysms, characteristic pathologic features of background diabetic retinopathy. In contrast, aminoguanidinetreated diabetic animals had only a 3.6-fold increase in acellular capillaries and no microaneurysms. These findings indicate that advanced glycosylation product accumulation contributes to the development of diabetic retinopathy and suggest that a anqidine may have future therapeutic use in this disorder.Pathologic retinal changes are found in virtually 100%o of patients having type I diabetes for 15 yr or longer (1). Underlying the complex clinical manifestations of diabetic retinopathy are two fundamental abnormalities: increased retinal vascular permeability and progressive retinal vessel closure (2, 3). Digested retinal vasculature preparations from diabetic patients and animals characteristically show early pericyte loss which is followed by acellular capillary development and microaneurysm formation (4,5). The severity of these changes is associated with the degree of chronic hyperglycemia to which the diabetic retina has been exposed, but the mechanisms by which elevated glucose levels cause retinal damage are currently not known (6, 7). Potentially important mechanisms include increased polyol pathway activity, activation of protein kinase C by de novo diacylglycerol synthesis, and altered cell/matrix functions induced by accumulated advanced glycosylation end products (8-11).Recently the nucleophilic hydrazine compound aminoguanidine has been shown to inhibit the formation of advanced glycosylation products on collagen and basement membrane both in vitro and in vivo (12,13 pepsin/0.2% HCL. After 10 min in a water bath at room temperature, the retina was subjected to digestion by 3% trypsin/0.2 M Tris for 3.5 hr at 370C to remove the inner limiting membrane. The sample was then placed on a glass slide, and further digestion with trypsin was monitored under a dissecting microscope. The intact isolated retinal vessel preparation was washed with distilled H20 and air-dried. Retinal vessel preparations were stained with periodic acid/ Schiff reagent/hematoxylin (15) and photographed using a

show abstract

Clinicopathologic Correlations in Diabetic Retinopathy

Cited by 85 publications

References 8 publications

White Dots as a Novel Marker of Diabetic Retinopathy Severity in Ultrawide Field Imaging

White Dots as a Novel Marker of Diabetic Retinopathy Severity in Ultrawide Field Imaging

Characterization of Diabetic Microaneurysms by Simultaneous Fluorescein Angiography and Spectral-Domain Optical Coherence Tomography

Aminoguanidine treatment inhibits the development of experimental diabetic retinopathy.

Contact Info

Product

Resources

About