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有关糖尿病性视网膜病变最早的毛细血管改变存在着争论,因为要了解严重视网膜病变的早期毛细血管改变是困难的。用眼底镜检查糖尿病性视网膜病变的早期征象被认为是微血管瘤。为了阐明糖尿病的早期血管改变,作者为166例糖尿病患者的272眼作了眼底荧光血管造影,这些患者的眼底事先用眼底镜检查都未发现糖尿病性视网膜病变。272眼中有181眼(占66.5%)荧光血管造影发现有视网膜血管改变,这些改变包括荧光素渗漏、毛细血管扩张、毛细血管充盈缺损、微血管瘤样点状扩张及微血管瘤。经统计分析及1～5年追踪观察得知此病的进展从荧光血管造影方面观察按下列顺序进行,即荧光素渗漏、毛细血管扩张、毛细血管充盈缺损、微血管瘤样点状扩张及微血管瘤。荧光素渗漏最多见,见于89.5%的患者,是糖尿病性视网
The earliest changes in capillaries related to diabetic retinopathy are debated, as understanding early capillary changes in severe retinopathy is difficult. The use of ophthalmoscopy to detect early signs of diabetic retinopathy is considered to be a microangioma. To clarify the early vascular changes in diabetes, the authors performed fundus fluorescein angiography in 272 eyes of 166 diabetic patients. No diabetic retinopathy was found in the fundus of the eye with funduscopic examination beforehand. There were 181 eyes (66.5%) of 272 eyes with retinal vascular changes detected by fluorescence angiography. These changes included fluorescein leakage, telangiectasia, capillary filling defect, MPA-like dilatation and microaneurysm. The statistical analysis and 1 to 5 years follow-up observation of the progress of the disease from the perspective of fluorescent angiography observed in the following order, namely, fluorescein leakage, telangiectasia, capillary filling defect, microvascular tumor-like dilatation and microvascular tumor. The most common fluorescein leakage, seen in 89.5% of patients, is diabetic retinopathy