Classification of proliferative diabetic retinopathy

• Published in: Graefe's archive for clinical and experimental ophthalmology Vol. 225; no. 4; p. 245
• Main Authors: Cardillo Piccolino, F, Zingirian, M, Mosci, C
• Format: Journal Article
• Language: English
• Published: Germany 01.07.1987
• Subjects: Capillaries - pathology; Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 2 - complications; Diabetic Retinopathy - classification; Diabetic Retinopathy - pathology; Diabetic Retinopathy - surgery; Female; Fluorescein Angiography; Humans; Ischemia - classification; Ischemia - pathology; Light Coagulation; Male; Retinal Vessels - pathology
• ISSN: 0721-832X
• DOI: 10.1007/bf02150141

Using panretinal fluorescein angiography, three patterns (A, B, C) of capillary nonperfusion were identified in 308 eyes with proliferative diabetic retinopathy. Statistical analysis showed that there was a significant association with different retinal complications and clinical parameters. Pattern A (83.7%: midperipheral location of capillary nonperfusion) occurs in type I and II diabetes and is associated with early retinal neovascularization and focal macular edema. Pattern B (8.1%: capillary exclusions disseminated on the whole retina) is typical of young type-I diabetics and is complicated by early disc new vessels and ischemic maculopathy. Pattern C (8.1%: capillary nonperfusion confined to the peripheral retina) is observed in type-I diabetic females and associated with multiple, retinal new vessels, without maculopathy. This study also demonstrated that eyes with pattern B retinal ischemia respond less well to laser treatment than eyes with other pattern types. Various pathogenetic factors could lead to these three distinct types of proliferative diabetic retinopathy.