Nonproliferative diabetic retinopathy with significant capillary nonperfusion.

A clinical study was carried out in 80 eyes of 50 diabetic patients with significant capillary nonperfusion at least in one eye. Panoramic photography of the fundus and wide-angle composite fluorescein angiography was performed in all cases. Forty-nine patients had type II diabetes. The mean age of the patients was 60 years and the mean duration of diabetes was 12.1 years; 46% of the patients had hypertensive vascular disease. Small neovascular tufts were observed in the iris sphincter in 20% of eyes. In addition, abnormal leakage of dye was observed in these eyes. Abnormal leakage of dye from the iris vessels was also observed in 9 of 20 eyes without clinically visible neovascularization. Numerous soft exudates distributed in a semicircular arc pattern were observed in 49% of eyes. Soft exudates were isolated and scarce in 37% of cases and were completely absent in 14% of eyes. Thus, in a substantial proportion of cases, the severity of the retinopathy could not be assessed by ophthalmoscopic findings alone.