Sato Y, Kamata A, Matsui M
Department of Ophthalmology, Nihon University School of Medicine, Chiyoda-ku, Japan.
Nippon Ganka Gakkai Zasshi. 1992 Oct;96(10):1306-10.
The authors studied 304 eyes (248 cases) affected by diabetic retinopathy in relation to venous abnormalities by ophthalmoscopy, slit lamp examination with contact lens and fluorescein angiography. The posterior pole and surrounding mid-peripheral area were examined. The subjects consisted of 225 eyes with pre-proliferative and 79 eyes with proliferative retinopathy. Fifty-six eyes (18%) had venous abnormalities: 17 of the 225 eyes (8%) with pre-proliferative retinopathy and 39 of the 79 eyes (49%) with proliferative retinopathy. In the 56 eyes with venous abnormalities. 39 (96%) showed beading. 14 (25%) showed looping and 2 (4%) showed duplication. All eyes which showed looping or duplication had proliferative retinopathy. The locations of the venous abnormalities were analyzed: 42% were in secondary branches, 27% in tertiary branches, 18% in primary branches, 10% in fourth branches and 3% in fifth branches. The portion of the fundus affected was upper temporal, lower temporal, upper nasal and lower nasal in 28%, 22%, 29% and 21%, respectively. Based on our results, eyes with looping or duplication on ophthalmoscopic or slit lamp examination, have an extremely high probability of being in some stage of proliferative retinopathy. Retinopathy should be confirmed by fluorescein angiography and photocoagulation should be performed as quickly as possible.
作者通过检眼镜检查、佩戴接触镜的裂隙灯检查和荧光素血管造影，研究了304只受糖尿病视网膜病变影响的眼睛（248例）与静脉异常的关系。对后极部及周边中周部区域进行了检查。受试者包括225只患有增殖前期视网膜病变的眼睛和79只患有增殖性视网膜病变的眼睛。56只眼睛（18%）存在静脉异常：225只增殖前期视网膜病变眼睛中有17只（8%），79只增殖性视网膜病变眼睛中有39只（49%）。在这56只存在静脉异常的眼睛中，39只（96%）表现为串珠样改变，14只（25%）表现为迂曲，2只（4%）表现为重复。所有表现为迂曲或重复的眼睛均患有增殖性视网膜病变。对静脉异常的位置进行了分析：42%位于二级分支，27%位于三级分支，18%位于一级分支，10%位于四级分支，3%位于五级分支。眼底受影响的部位分别为颞上、颞下、鼻上和鼻下，各占28%、22%、29%和21%。根据我们的结果，在检眼镜或裂隙灯检查中表现为迂曲或重复的眼睛，极有可能处于增殖性视网膜病变的某个阶段。视网膜病变应通过荧光素血管造影确诊，并应尽快进行光凝治疗。
