Clinicopathologic correlations in diabetic retinopathy. I. Histology and fluorescein angiography of microaneurysms.

A patient with adult-onset diabetes mellitus was referred with a diagnosis of malignant melanoma of the choroid of the left eye. A nonproliferative type of diabetic retinopathy was present, which was studied and documented by stereoscopic fundus photographs and fluorescein angiograms. Following enucleation, the microangiopathies were correlated histologically, using the retinal trypsin digest technique. Four types of microaneurysms were seen histologically that were believed to represent stages in the development of this lesion. Most thin-walled aneurysms tightly packed with erythrocytes did not fluoresce. Aneurysms that were hypercellular and those with thick walls showed early and late fluorescence. Intraretinal microvascular abnormalities were hypercellular dilated channels. Those that take origin from terminal arterioles are believed to represent attempts at neovascularization.