Sato Y, Kamata A, Matsui M
Department of Ophthalmology, Nihon University School of Medicine, Tokyo, Japan.
Jpn J Ophthalmol. 1993;37(2):136-42.
The authors studied 304 eyes (248 cases) affected by diabetic retinopathy in relation to venous abnormalities. The posterior pole and surrounding mid-peripheral area were examined by ophthalmoscopy, slit-lamp examination with contact lens and fluorescein angiography. There were 225 eyes with preproliferative and 79 eyes with proliferative retinopathy. Fifty-six eyes (18%) of the total eyes had venous abnormalities: 17 (8%) of the 225 eyes with preproliferative retinopathy and 39 (49%) of the 79 eyes with proliferative retinopathy. In the 56 eyes with venous abnormalities, 54 (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。通过检眼镜、带接触镜的裂隙灯检查和荧光素血管造影对后极部和周边中周部区域进行检查。有225只眼睛患有增殖前期视网膜病变，79只眼睛患有增殖性视网膜病变。在所有眼睛中，56只（18%）有静脉异常：在225只患有增殖前期视网膜病变的眼睛中有17只（8%），在79只患有增殖性视网膜病变的眼睛中有39只（49%）。在56只存在静脉异常的眼睛中，54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。分析了静脉异常的位置：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。眼底受累部分分别为颞上、颞下、鼻上和鼻下，比例分别为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。
