[Development of neovascularization of the optic papilla, retina and iris. Dependence on site and extent of retinal ischemia].
BACKGROUND
Is it possible to find a correlation between the localisation of neovascularisations and the localisation and extension of the retinal ischemia? Ischemia was recognized not as capillary non-perfusion but as impaired retinal perfusion.


METHODS
Patients with retinal ischemia like in diabetic retinopathy (n = 95), central retinal vein occlusion (n = 9), ischemic ophthalmopathia (n = 8) and branch vein occlusion (n = 5) who had neovascularisations were examined. The localisation of retinal ischemia and the localisation of neovascularisations were diagnosed by fluorescein angiography and biomicroscopy.


RESULTS
Neovascularisations at the different places were observed with different frequencies depending on localisation and extension of retinal ischemia. Panretinal ischemia caused by diabetic retinopathy type B was followed by neovascularisations at iris in 69.2% with participation of the anterior chamber angle in 61.1%. In diabetic retinopathy type A with limited retinal ischemia neovascularisations of iris and chamber angle were significantly less frequent (31.7%/25%). On the contrary panretinal ischemia caused by central retinal vein occlusion was followed by neovascularisations elsewhere in 11.1%; in diabetic retinopathy type C with limited retinal ischemia neovascularisations elsewhere were observed only in 66.7%.


CONCLUSIONS
There is a relationship between the localisation of the neovascularisations and the localisation and the extension of the retinal ischemia. The differentiation of PDR in different ischemic types is confirmed by different frequencies of the neovascularisation sites depending on the ischemic type. The explanation for the frequent finding of neovascularisations at the disk caused by the peripheral type of diabetic retinopathy is a communication via Cloquet's canal between periperal retina and papilla.
Universitäts-Augenklinik Bochum im Knappschaftskrankenhaus Bochum-Langendreer.
D
D
Nahberger
R
R
Meyer-Schwickerath
O
O
Saygili
U
U
Gronemeyer
D003930:Diabetic Retinopathy / Q000150:complications / Q000175:diagnosis; D005451:Fluorescein Angiography; D006801:Humans; D007498:Iris / Q000098:blood supply*; D007511:Ischemia / Q000150:complications / Q000175:diagnosis*; D009389:Neovascularization, Pathologic / Q000175:diagnosis* / Q000209:etiology; D009882:Ophthalmic Nerve / Q000098:blood supply; D009887:Ophthalmoscopy; D009898:Optic Disk / Q000098:blood supply*; D012164:Retinal Diseases / Q000150:complications / Q000175:diagnosis*; D015861:Retinal Neovascularization / Q000175:diagnosis* / Q000209:etiology; D012170:Retinal Vein Occlusion / Q000150:complications / Q000175:diagnosis; D012189:Retrospective Studies