VASCULAR CHANGES IN DIABETES WITH PARTICULAR REFERENCE TO THE RETINAL VESSELS: Preliminary Report

Abstract

True aneurysms, most of which are saccular diverticula, are found in diabetic retinopathy. They are largely confined to the venous side of the capillary network, and they are situated, for the most part, in the inner nuclear layer in the course of the capillaries which link the deeper and more superficial retinal capillary plexuses. The deeper plexus is a more closely knit meshwork than the superficial one, and therefore venous stasis affects the former more than the latter. The preference of the micro-aneurysms for the inner nuclear layer may be purely an expression of the increased stasis in that region. The retina was the only part of the eye and of the body in which micro-aneurysms were found. All the cases, in a small series, of intercapillary glomerulosGlerosis of the nodular type (Kimmelstiel-Wilson''s disease of the kidney) were associated with diabetic retinopathy. These vascular lesions of the kidney and retina may be manifestations of the same pathological process only modified by the different anatomical structure of the 2 organs. The intercapillary (and perhaps intramural) deposits of hyalin in the former may be closely related to the waxy exudates in the retina which follow degeneration and proliferation of the walls of the retinal vessels. However, diabetic retinopathy can exist in the absence of Kimmelstiel-Wilson''s disease of the kidney.