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Clinical studies on macular changes in diabetic retinopathy 3. studies on pathologies of retinal capillary beds in and around the macula in diabetic retinopathy


, : Clinical studies on macular changes in diabetic retinopathy 3. studies on pathologies of retinal capillary beds in and around the macula in diabetic retinopathy. Nippon Ganka Gakkai Zasshi 88(7): 1084-1092

By means of fluorescein angiography, 230 eyes (192 cases) of diabetic retinopathy concerning pathologies of their retinal capillary beds within 1 disc diameter in and around the macula were studied. The subjects consisted of 57 eyes of background, 100 eyes of pre-proliferative and 73 eyes of proliferative diabetic retinopathies. Among the 230 eyes, 118 eyes (51%) showed non-perfused capillaries which occupied < 1/4 of capillary beds in and around the macula (grade 1); 72 eyes (31%) showed non-perfused capillary beds which occupied 1/4 up to 1/2 in and around the macula (grade 2); 27 eyes (12%) showed non-perfused capillary beds which occupied 1/2 up to 3/4 in and around the macula (grade 3); and 13 eyes (6%) showed non-perfused capillary beds which occupied more than 3/4 in and around the macular (grade 4). The visual acuities (mean .+-. SD) were 0.99 .+-. 0.27 in grade 1, 0.78 .+-. 0.34 in grade 2, 0.60 .+-. 0.35 in grade 3 and 0.17 .+-. 0.13 in grade 4. Capillary closure became severe with the advance of retinopathy and the incidence of deterioration in visual acuity became higher with the advance of capillary closure. Regarding the types of macular changes, deteriorated visual acuity was attributed to ischemic involvement of the macula in grade 4, while in grades 1-3, it was attributed to increased permeability of the capillaries. The ischemic maculopathy should be the condition with arteriolar obstruction and non-perfused capillary beds which occupied more than 3/4 in and around the macula having no evidence of macular edema.

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