Arterial Fluorescein Studies in Diabetic Retinopathy

Abstract

Fifteen patients with diabetic retinopathy were studied by fluorescence angiography after injections of sodium fluorescein into the innominate artery. This method allows individual capillaries to be visualized in life and restudied at intervals. Microaneurysms were the most conspicuous feature. Many were situated on vessels at the edge of areas of capillary closure but others were located on capillaries which appeared otherwise normal. Regions of capillary closure were common and occurred even in the milder retinopathies. The areas involved ranged from about 0.1 mm. up to 5 mm. in diameter. Other capillary changes included general dilatation, shunt vessel formation and new vessel systems. Abnormalities of arterioles were seen in severe retinopathy. Three patients who had extensive destruction of the perimacular capillary bed also had occlusion of arterioles and venules surrounding the macula. These observations are discussed in relation to the pathogenesis of diabetic retinal vascular disease.