Sdobnikova S V, Fedorov A A, Chekmareva I A, Stoliarenko G E, Mazurina N K
Vestn Oftalmol. 2002 Mar-Apr;118(2):20-1.
In order to elucidate the relationships between posterior ocular structures, 48 samples of epiretinal membranes were examined, which were obtained during transcilliary vitrectomy for proliferative diabetic retinopathy of different stages (29 patients with type I diabetes mellitus and 19 with type 2). The findings of morphological analysis and preoperative ophthalmoscopy (color photographs) demonstrated clinical and morphological correlations of stages of proliferative diabetic retinopathy. Impossibility of differential diagnosis between posterohyaloid membrane and newly formed tissue by clinical methods and impossibility of their mechanical intraoperative separation allow us to regard the stages of proliferative process as stages in changes of the posterohyaloid membrane proper. The posterohyaloid membrane is detected clinically and morphologically only in the presence of pathological changes, including diabetic retinopathy. We detected the following clinical histological correlations of proliferative process stages in diabetic retinopathy: 1) glial; 2) glio-vascular; 3) glio-vascular-fibrous; 4) fibrovascular; 5) fibrous (cicatricial). The histology of stages of proliferative diabetic retinopathy and correlation of histological findings with the clinical (ophthalmoscopic) picture of the process are described in detail. Recommendations on the treatment of each of these stages are offered.
为了阐明眼后段结构之间的关系，对48份视网膜前膜样本进行了检查，这些样本取自不同阶段增殖性糖尿病视网膜病变患者的经睫状体玻璃体切除术（29例1型糖尿病患者和19例2型糖尿病患者）。形态学分析结果和术前检眼镜检查（彩色照片）显示了增殖性糖尿病视网膜病变各阶段的临床与形态学相关性。临床方法无法鉴别后玻璃体膜与新形成组织，术中也无法将它们机械分离，这使我们将增殖过程的各阶段视为后玻璃体膜本身的变化阶段。后玻璃体膜仅在存在包括糖尿病视网膜病变在内的病理变化时才能在临床和形态学上被检测到。我们检测到糖尿病视网膜病变增殖过程各阶段的以下临床组织学相关性：1）胶质；2）胶质血管；3）胶质血管纤维；4）纤维血管；5）纤维（瘢痕）。详细描述了增殖性糖尿病视网膜病变各阶段的组织学以及组织学结果与该疾病临床（检眼镜）表现的相关性。并针对这些阶段中的每个阶段提供了治疗建议。
