Abstract OF THE degenerative changes of diabetes mellitus, retinopathy is one of the more serious for the patient and has been the subject of increasing study in the past few years. Much progress has been made in knowledge of the pathology and the specificity of the lesion. It has been demonstrated that the characteristic lesion of diabetic retinopathy is the capillary aneurysm.1 These aneurysms appear as pinpoint dots, which were previously thought to be punctate hemorrhages. Punctate hemorrhages do occur and are difficult to distinguish ophthalmoscopically from the aneurysms. The hemorrhages tend to change fairly rapidly, while the aneurysms remain unchanged for longer periods. Other retinal hemorrhages, of varying sizes, may be located in the superficial or the deep layers of the retina. New hemorrhages tend to occur in showers. Hard, yellowish, discrete exudates may also be seen, as well as phlebosclerosis. Diabetic retinopathy is generally progressive, but remissions occur. References 1. Friedenwald, J. S.: A New Approach to Some Problems of Retinal Vascular Disease: Jackson Memorial Lecture , Am. J. Ophth. 32:487, 1949 2. Diabetic Retinopathy: Fourth Francis I. Proctor Lecture , Friedenwald Am. J. Ophth. 33:1187, 1950. 3. Ballantyne, A. J., and Loewenstein, A.: Retinal Micro-Aneurysms and Punctate Hemorrhages , Brit. J. Ophth. 28:593, 1944.Crossref 4. Saskin, E.; Waldman, S., and Pelner, L.: Diabetic Retinopathy: New Approach to Therapy with Steroid Hormone-Testosterone Propionate , Am. J. Ophth. 34:613, 1951. 5. Pelner, L.; Davidson, B.; Waldman, S., and Margolis, R.: Role of Choline Chloride in the Treatment of Certain Cases of Diabetes Mellitus: Studies of Liver Dysfunction , New York J. Med. 48:523, 1948. 6. Rabinowitch, I. M.: A Note on the Bilirubin Content of Blood and Urobilinogen Content of Urine in Diabetes Mellitus , Brit. J. Exper. Path. 17:249, 1936 7. The Van den Bergh Reaction in Diabetes Mellitus , Rabinowitch Brit. J. Exper. Path. 7:155, 1926 8. Relationship Between Impairment of Liver Function and Premature Development of Arteriosclerosis in Diabetes Mellitus , Canad. M. A. J. 58:547, 1948. 9. Biskind, M. S., and Schreier, H.: On the Significance of Nutritional Deficiency in Diabetes Mellitus , Exper. Med. & Surg. 3:299, 1945. 10. Soskin, S.; Allweiss, M. D., and Cohn, D. J.: Influence of the Pancreas and the Liver upon the Dextrose Tolerance Curve , Am. J. Physiol. 109:155, 1934. 11. (a) Lewis, L. A.; Schneider, R. W., and McCullagh, E. P.: Tiselius Electrophoresis Studies of Plasma Proteins in Diabetes Mellitus , J. Clin. Endocrinol. 4:535, 1944. 12. (b) Schneider, R. W.; Lewis, L. A., and McCullagh, E. P.: Plasma Proteins: Alteration in Diabetic Retinitis , Am. J. M. Sc. 212:462, 1946. 13. (c) Lewis, L. A.; Moses, J., and Schneider, R. W.: Plasma Proteins: Alteration in Alloxan Diabetic Rabbits, Especially in Relation to Ocular Damage , Am. J. M. Sc. 213:214, 1947. 14. Kinsell, L. W.: Factors Affecting Protein Balance in the Presence of Chronic Viral Liver Damage , Gastroenterology 11:672, 1948. 15. Bedell, A. J.: Fundus Changes in 205 Diabetics , Tr. Ophth. Soc. U. Kingdom 59( (Pt.1) ):219, 1939. 16. The supplies of Oreton and Gynetone used in this study were provided through the courtesy of George Babcock Jr., M.D., of the Division of Clinical Research, Schering Corporation, Bloomfield, N. J. 17. The statistical analysis was done by E. Douglass Burdick, Ph.D., Associate Professor of Statistics, University of Pennsylvania.
A.M.A. Archives of Ophthalmology – American Medical Association
Published: Sep 1, 1953
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