Agardh E, Cavallin-Sjöberg U
Department of Ophthalmology, University Hospital, Lund, Sweden.
Retina. 1998;18(5):420-3. doi: 10.1097/00006982-199805000-00006.
To evaluate peripheral nonproliferative retinopathy by comparing fundus photograph changes with angiographic findings in type 1 diabetic patients with a long duration of diabetes.
Thirty-eight patients with type 1 diabetes, without proliferative retinopathy and with at least 30 years of diabetes duration, were selected to be examined with fundus photography and fluorescein angiography. Two levels of retinopathy degree were identified. In fundus photographs, level 1 represented eyes with no or mild peripheral background retinopathy (i.e., five or fewer pinpoint hemorrhages or microaneurysms), and level 2, peripheral moderate retinopathy (i.e., dot-and-blot hemorrhages or intraretinal microvascular abnormalities or cotton-wool spots). In the angiograms, level 1 represented a nearly normal vascular pattern with occasional microaneurysms and level 2 comprised morphologic signs of abnormal circulation such as dilated capillaries, arteriolar abnormalities, intraretinal microvascular abnormalities, and capillary loss of 3 or more disk diameters from the center of the macula. The angiograms and fundus photographs were graded separately and the results of the grading were compared.
The peripheral parts of the retina could be visualized with a high photographic quality on both fundus photographs and angiograms in 66 eyes. On fundus photographs, both graders found level 1 retinopathy in 47 of 66 eyes and level 2 retinopathy in 13 of 66 eyes. On angiograms, both graders found level 1 retinopathy in 46 of 66 eyes, whereas level 2 retinopathy was seen in 16 of 66 eyes. In most eyes with no or mild retinopathy, the angiograms were interpreted as nearly normal (41 of 47), and in most eyes with moderate retinopathy, they were interpreted as abnormal (10 of 13).
The degree of peripheral diabetic retinal changes based on grading of fundus photographs was comparable to that based on angiograms in 51 of 66 (77%) eyes.
通过比较长期患1型糖尿病患者的眼底照片变化与血管造影结果，评估外周非增殖性视网膜病变。
选取38例无增殖性视网膜病变且糖尿病病程至少30年的1型糖尿病患者，进行眼底照相和荧光素血管造影检查。确定了两个视网膜病变程度级别。在眼底照片中，1级表示无或仅有轻度外周背景视网膜病变的眼睛（即5个或更少的点状出血或微动脉瘤），2级表示外周中度视网膜病变（即斑点状出血、视网膜内微血管异常或棉絮斑）。在血管造影中，1级表示血管形态近乎正常，偶见微动脉瘤，2级包括异常循环的形态学征象，如毛细血管扩张、小动脉异常、视网膜内微血管异常以及距黄斑中心3个或更多视盘直径范围的毛细血管缺失。分别对血管造影和眼底照片进行分级，并比较分级结果。
66只眼中，眼底照片和血管造影均能以高质量显示视网膜外周部分。在眼底照片上，两位分级者在66只眼中的47只发现1级视网膜病变，13只发现2级视网膜病变。在血管造影中，两位分级者在66只眼中的46只发现1级视网膜病变，而66只眼中的16只可见2级视网膜病变。在大多数无或轻度视网膜病变的眼中，血管造影被解读为近乎正常（47只中的41只），而在大多数中度视网膜病变的眼中，血管造影被解读为异常（13只中的10只）。
在66只眼中的51只（77%）眼中，基于眼底照片分级的外周糖尿病视网膜病变程度与基于血管造影的程度相当。
