A non-atheromatous proliferative vascular lesion of the retina in diabetes mellitus: Role in the etiology of diabetic retinopathy

Abstract

The frequency of inflammatory, thrombotic, atheromatous, hemodynamic and proliferative lesions of retinal vessels have been compared in thirty-four eyes of diabetic subjects and fifty eyes of nondiabetic control subjects. Inflammatory lesions occurred with a slightly greater frequency among the diabetic subjects, but this was attributed, in part, to reaction to hemorrhage which occurs more frequently in diabetic subjects. Thrombotic and atheromatous lesions were found only rarely in both groups. Hemodynamic lesions were found with slightly greater frequency among diabetic subjects, but the difference was of about the same order of magnitude as the difference in frequency of hypertension. Proliferative lesions were found over three and a half times more frequently in diabetic than in non-diabetic persons. The etiology and pathogenesis of these proliferative lesions are discussed in relation to current concepts of the origin of the vascular complications of diabetes. It is pointed out that the proliferative vascular lesion most closely resembles similar lesions produced by immunogenic mechanisms. The possibility that an immunogenic mechanism may be responsible for the vascular complications of diabetes is discussed.