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October 1, 1967

The Role of Lipid Thrombi in the Pathogenesis of Diabetic Retinopathy

Author Affiliations


From the departments of medicine and pathology, Western Reserve School of Medicine and Cleveland Metropolitan General Hospital, Cleveland.

Arch Intern Med. 1967;120(4):397-407. doi:10.1001/archinte.1967.04410010011002

DESPITE the prominence of the vascular changes in diabetic retinopathy, the nature of the angiopathy is not fully understood. In particular, the concepts that retinal arterioles and capillaries are occluded by lipid thrombi and that the capillary thrombi are of importance in the genesis of microaneurysms, have not been appreciated. The purpose of this article is to focus attention on these unique pathological changes and to document their relationship to microaneurysmal formation and to certain other retinal lesions of diabetic retinopathy.

Materials and Methods  The clinical records of 13 patients with diabetes mellitus, in whom the eyes had been removed postmortem, were reviewed. The clincial data in each case included the results of a history and physical examination by at least two physicians. In most instances there were multiple admissions to the hospital and visits to the outpatient clinics so that sequential retinal changes were carefully recorded. Consultations with the