Abstract
Five insulin dependent diabetic patients are reported on who had a few small retinal cotton-wool spots or 'soft exudates' either totally isolated or associated with fewer than 10 microaneurysms. These observations suggest that cotton-wool spots may be an early finding in diabetic retinopathy. Significant biological abnormalities in these patients were high levels of glycosylated haemoglobin and mild increases in thrombin generation, indicating slight activation of the coagulation system. The possible significance of these clinical and biological findings is discussed.
Full text
PDFImages in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- ASHTON N. Arteriolar involvement in diabetic retinopathy. Br J Ophthalmol. 1953 May;37(5):282–292. doi: 10.1136/bjo.37.5.282. [DOI] [PMC free article] [PubMed] [Google Scholar]
- ASHTON N. Diabetic retinopathy: a new approach. Lancet. 1959 Oct 24;2(7104):625–630. doi: 10.1016/s0140-6736(59)91407-2. [DOI] [PubMed] [Google Scholar]
- ASHTON N., HARRY J. THE PATHOLOGY OF COTTON WOOL SPOTS AND CYTOID BODIES IN HYPERTENSIVE RETINOPATHY AND OTHER DISEASES. Trans Ophthalmol Soc U K. 1963;83:91–114. [PubMed] [Google Scholar]
- Ashton N. Pathophysiology of retinal cotton-wool spots. Br Med Bull. 1970 May;26(2):143–150. doi: 10.1093/oxfordjournals.bmb.a070766. [DOI] [PubMed] [Google Scholar]
- Borsey D. Q., Prowse C. V., Gray R. S., Dawes J., James K., Elton R. A., Clarke B. F. Platelet and coagulation factors in proliferative diabetic retinopathy. J Clin Pathol. 1984 Jun;37(6):659–664. doi: 10.1136/jcp.37.6.659. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bursell S. E., Delori F. C., Yoshida A., Parker J. S., Collas G. D., McMeel J. W. Vitreous fluorophotometric evaluation of diabetics. Invest Ophthalmol Vis Sci. 1984 Jun;25(6):703–710. [PubMed] [Google Scholar]
- COGAN D. G., TOUSSAINT D., KUWABARA T. Retinal vascular patterns. IV. Diabetic retinopathy. Arch Ophthalmol. 1961 Sep;66:366–378. doi: 10.1001/archopht.1961.00960010368014. [DOI] [PubMed] [Google Scholar]
- Chahal P., Fallon T. J., Jennings S. J., Chowienczyk P. J., Kohner E. M. Vitreous fluorophotometry in patients with no or minimal diabetic retinopathy. Diabetes Care. 1986 Mar-Apr;9(2):134–139. doi: 10.2337/diacare.9.2.134. [DOI] [PubMed] [Google Scholar]
- Coller B. S., Frank R. N., Milton R. C., Gralnick H. R. Plasma cofactors of platelet function: correlation with diabetic retinopathy and hemoglobins Ala-c. Ann Intern Med. 1978 Mar;88(3):311–316. doi: 10.7326/0003-4819-88-3-311. [DOI] [PubMed] [Google Scholar]
- Corash L., Tan H., Gralnick H. R. Heterogeneity of human whole blood platelet subpopulations. I. Relationship between buoyant density, cell volume, and ultrastructure. Blood. 1977 Jan;49(1):71–87. [PubMed] [Google Scholar]
- Cunha-Vaz J., Faria de Abreu J. R., Campos A. J. Early breakdown of the blood-retinal barrier in diabetes. Br J Ophthalmol. 1975 Nov;59(11):649–656. doi: 10.1136/bjo.59.11.649. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dahl-Jørgensen K., Brinchmann-Hansen O., Hanssen K. F., Sandvik L., Aagenaes O. Rapid tightening of blood glucose control leads to transient deterioration of retinopathy in insulin dependent diabetes mellitus: the Oslo study. Br Med J (Clin Res Ed) 1985 Mar 16;290(6471):811–815. doi: 10.1136/bmj.290.6471.811. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Davì G., Rini G. B., Averna M., Novo S., Di Fede G., Mattina A., Notarbartolo A., Strano A. Enhanced platelet release reaction in insulin-dependent and insulin-independent diabetic patients. Haemostasis. 1982;12(3):275–281. doi: 10.1159/000214683. [DOI] [PubMed] [Google Scholar]
- Ditzel J. Haemorheological factors in the development of diabetic microangiopathy. Br J Ophthalmol. 1967 Dec;51(12):793–803. doi: 10.1136/bjo.51.12.793. [DOI] [PMC free article] [PubMed] [Google Scholar]
- ESMANN V., LUNDBAEK K., MADSEN P. H. TYPES OF EXUDATES IN DIABETIC RETINOPATHY. Acta Med Scand. 1963 Sep;174:375–384. doi: 10.1111/j.0954-6820.1963.tb07936.x. [DOI] [PubMed] [Google Scholar]
- Gabbay K. H. The sorbitol pathway and the complications of diabetes. N Engl J Med. 1973 Apr 19;288(16):831–836. doi: 10.1056/NEJM197304192881609. [DOI] [PubMed] [Google Scholar]
- Gralnick H. R., Marchesi S., Givelber H. Intravascular coagulation in acute leukemia: clinical and subclinical abnormalities. Blood. 1972 Nov;40(5):709–718. [PubMed] [Google Scholar]
- Gralnick H. R., Williams S. B., Morisato D. K. Effect of multimeric structure of the factor VIII/von Willebrand factor protein on binding to platelets. Blood. 1981 Aug;58(2):387–397. [PubMed] [Google Scholar]
- Gunkel R. D., Cogan D. G. Colorimetry by a new principle. Arch Ophthalmol. 1978 Feb;96(2):331–334. doi: 10.1001/archopht.1978.03910050193016. [DOI] [PubMed] [Google Scholar]
- Higgins K. E., Jaffe M. J., Coletta N. J., Caruso R. C., de Monasterio F. M. Spatial contrast sensitivity. Importance of controlling the patient's visibility criterion. Arch Ophthalmol. 1984 Jul;102(7):1035–1041. doi: 10.1001/archopht.1984.01040030837028. [DOI] [PubMed] [Google Scholar]
- Hoyer L. W., Shainoff J. R. Factor VIII-related protein circulates in normal human plasma as high molecular weight multimers. Blood. 1980 Jun;55(6):1056–1059. [PubMed] [Google Scholar]
- Kohner E. M., Dollery C. T., Bulpitt C. J. Cotton-wool spots in diabetic retinopathy. Diabetes. 1969 Oct;18(10):691–704. doi: 10.2337/diab.18.10.691. [DOI] [PubMed] [Google Scholar]
- Kohner E. M., Dollery C. T., Paterson J. W., Oakley N. W. Arterial fluorescein studies in diabetic retinopathy. Diabetes. 1967 Jan;16(1):1–10. doi: 10.2337/diab.16.1.1. [DOI] [PubMed] [Google Scholar]
- Kohner E. M., Henkind P. Correlation of fluorescein angiogram and retinal digest in diabetic retinopathy. Am J Ophthalmol. 1970 Mar;69(3):403–414. doi: 10.1016/0002-9394(70)92273-7. [DOI] [PubMed] [Google Scholar]
- Kohner E. M. The problems of retinal blood flow in diabetes. Diabetes. 1976;25(2 Suppl):839–844. [PubMed] [Google Scholar]
- Krogsaa B., Lund-Andersen H., Mehlsen J., Sestoft L., Larsen J. The blood-retinal barrier permeability in diabetic patients. Acta Ophthalmol (Copenh) 1981 Oct;59(5):689–694. doi: 10.1111/j.1755-3768.1981.tb08735.x. [DOI] [PubMed] [Google Scholar]
- Krupin T., Waltman S. R., Oestrich C., Santiago J., Ratzan S., Kilo C., Becker B. Vitreous fluorophotometry in juvenile-onset diabetes mellitus. Arch Ophthalmol. 1978 May;96(5):812–814. doi: 10.1001/archopht.1978.03910050418002. [DOI] [PubMed] [Google Scholar]
- Lanthony P. The desaturated panel D-15. Doc Ophthalmol. 1978 Oct 16;46(1):185–189. doi: 10.1007/BF00174107. [DOI] [PubMed] [Google Scholar]
- Lauritzen T., Frost-Larsen K., Larsen H. W., Deckert T. Effect of 1 year of near-normal blood glucose levels on retinopathy in insulin-dependent diabetics. Lancet. 1983 Jan 29;1(8318):200–204. doi: 10.1016/s0140-6736(83)92585-0. [DOI] [PubMed] [Google Scholar]
- Lauritzen T., Frost-Larsen K., Larsen H. W., Deckert T., Keiding N., Nielsen G. Continuous subcutaneous insulin. Lancet. 1983 Jun 25;1(8339):1445–1446. doi: 10.1016/s0140-6736(83)92394-2. [DOI] [PubMed] [Google Scholar]
- McMillan D. E. Plasma protein changes, blood viscosity, and diabetic microangiopathy. Diabetes. 1976;25(2 Suppl):858–864. [PubMed] [Google Scholar]
- Mustand J. F., Packham M. A. Platelets and diabetes mellitus. N Engl J Med. 1984 Sep 6;311(10):665–667. doi: 10.1056/NEJM198409063111010. [DOI] [PubMed] [Google Scholar]
- Prager T. C., Chu H. H., Garcia C. A., Anderson R. E., Field J. B., Orzeck E. A., Comstock J. P. The use of vitreous fluorophotometry to distinguish between diabetics with and without observable retinopathy: effect of vitreous abnormalities on the measurement. Invest Ophthalmol Vis Sci. 1983 Jan;24(1):57–65. [PubMed] [Google Scholar]
- Rao A. K., Goldberg R. E., Walsh P. N. Platelet coagulant activities in diabetes mellitus. Evidence for relationship between platelet coagulant hyperactivity and platelet volume. J Lab Clin Med. 1984 Jan;103(1):82–92. [PubMed] [Google Scholar]
- Rosove M. H., Frank H. J., Harwig S. S., Berliner J. Plasma beta-thromboglobulin is correlated with platelet adhesiveness to bovine endothelium in patients with diabetes mellitus. Thromb Res. 1985 Jan 15;37(2):251–258. doi: 10.1016/0049-3848(85)90013-1. [DOI] [PubMed] [Google Scholar]
- Toussaint D. Fluoroangiographie de la rétine dans le diabète. J Fr Ophtalmol. 1982;5(11):733–739. [PubMed] [Google Scholar]
- Yamana Y., Ohnishi Y., Taniguchi Y., Ikeda M. Early signs of diabetic retinopathy by fluorescein angiography. Jpn J Ophthalmol. 1983;27(1):218–227. [PubMed] [Google Scholar]