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It has been accepted for many years that the occurrence of diabetic retinitis is based on associated arteriosclerosis, whether hypertensive or nonhypertensive. Yet the ophthalmologist is able to identify this condition in a large percentage of cases as a definite clinical entity. Extensive clinical experience has brought out certain points in differential diagnosis which, though useful in practical application, lack force, because no satisfactory pathologic explanation has been offered.
In ophthalmoscopic study of diabetic persons one cannot fail to note the frequency of hemorrhages, sometimes petechial and sometimes massive. Large hemorrhages are usually preceded by engorgement and irregularity of caliber of retinal veins, with a tendency to thrombosis. These signs may be seen in the absence of arteriosclerosis or out of proportion to severity of arteriolar hypertensive disease and, furthermore, in spite of normal renal function.
It would appear that while the presence of hyperglycemia may be responsible for metabolic
AGATSTON A. CLINICOPATHOLOGIC STUDY OF DIABETIC RETINITIS. Arch Ophthalmol. 1940;24(2):252–257. doi:10.1001/archopht.1940.00870020044005
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