Organised macular plaques in exudative diabetic maculopathy.

Abstract

SUMMARY Plaques of hard exudate measuring 0-5 to 10 disc diameters, which occurred in 5 eyes of 4 patients with diabetic maculopathy, showed complete organisation in 8 to 18 months with the formation of scars measuring 0-2 to 0 5 disc diameters. Spontaneous progression and regression of hard exudate in diabetic maculopathy was described by King et al.1 and Dobree,2 who found that plaque formation required years for resolution and was not followed by visual recovery. In a previous report3 we described the pathology of an organised macular plaque in exudative diabetic maculopathy and observed that the fibrous replacement was partly retinovascular and partly pigment epithelial in origin, suggesting that it was a specific pathological entity. The present study reports the resolution of mnacular plaques accompanied by organisation in 5 eyes of 4 patients with diabetic maculopathy. This late clinical appearance, which is fully described for the first time, may be the only ophthalmoscopic evidence that a severe exudative maculopathy has been primarily responsible for severe visual loss, and should be differentiated from disciform macular degeneration in older patients.

The relation between visual acuity, fixation stability, and the size and location of foveal hard exudates after photocoagulation for diabetic maculopathy

“…Previous studies of patients with diabetic maculopathy have shown that hard exudates persisting over time tend to have a deleterious effect on visual acuity and may even lead to the formation of foveal scars [9,16]. These studies have either assessed the severity of hard exudates semi-quantitatively or the retinal area covered by hard exudate has been estimated with the disc area as reference; hence, precise measurements of changes in the hard exudate area have not been obtained.…”

Influence of Serum Lipid Fractions on the Course of Diabetic Macular Edema after Photocoagulation

“…HDL cholesterol was unrelated to the severity of any diabetic le sions in this study. Hard exudates consist of glyco-and li poprotein, phospholipid and fatty acids [14]. The usual model in the pathogenesis of hard exudates is an extravasa tion of intravascular components due to focal leakages from microaneurysms.…”

Clinical Analysis of 50 Cases of Diabetic Maculopathy

“…18 Clinical features include enlarged foveal avascular zone, which is normally 300-500 microns and this is indicated by the presence of increased capillary dropouts on FFA. 19 , thread-like arteries and large retinal haemorrhages.…”