Abstract
Background
The structure of the vitreous body is known to play an important role in the pathogenesis of proliferative diabetic retinopathy (PDR). The purpose of this study was to ascertain the pattern of fibrous membrane proliferation in PDR focusing on pre-optic disc canal-like fibrous proliferation.
Methods
The investigation comprised two parts. The first, prospective study involved examining ten eyes of ten patients with PDR who underwent triamcinolone acetonide-assisted pars plana vitrectomy (TA-PPV). The presence of canal-like intravitreous structures was determined during TA-PPV. The second, retrospective study included analysis of photographs and clinical records of 235 eyes examined in 207 patients with PDR. The clinical and surgical records of the 235 eyes treated with PPV were reviewed and were categorized into four groups based upon the pattern of fibrous proliferation (optic disc type, pre-cortical pocket type, mixed type, or other). Each clinical feature was studied. The clinical features of the four groups of PDR were compared.
Results
A pre-optic disc canal-like structure was observed in seven of the ten eyes. In the retrospective study, 25 eyes (10.7%) were classified as optic disc type, 16 eyes (6.9%) as pre-cortical pocket type, 68 eyes (29.1%) as mixed type, and 126 eyes (53.4%) as other types. The patients with the optic disc type were significantly younger than the other three groups (P=0.02). Other clinical features and post-operative outcome were not significantly different between the groups.
Conclusions
A pre-optic disc canal-like structure, probably Cloquet’s canal and the area of Martegiani, was present in PDR eyes. The PDR patients with fibrous proliferation of this structure were younger than those with other patterns of fibrous proliferation.
Similar content being viewed by others
References
Davis MD (1965) Vitreous contraction in proliferative diabetic retinopathy. Arch Ophthalmol 74:979–982
Enaida H, Sakamoto T, Ueno A et al (2003) Submacular deposition of triamcinolone acetonide after triamcinolone-assisted vitrectomy. Am J Ophthalmol 135:243–246
Enaida H, Hata Y, Ueno A et al (2003) Possible benefits of triamcinolone-assisted pars plana vitrectomy for retinal diseases. Retina 23:764–770
Foos RY, Wheeler NC (1982) Vitreoretinal juncture. Synchysis senilis and posterior vitreous detachment. Ophthalmology 89:1502–1512
Gardner TW, Blankenship GW (1994) Proliferative diabetic retinopathy: principles and techniques of surgical treatment. In: Ryan SJ (ed) Retina. Mosby, St Louis, pp 2436–2483
Henkind P (1978) Ocular neovascularization. The Krill memorial lecture. Am J Ophthalmol 85:287–301
Hirata C, Nakano K, Nakamura N et al (1997) Advanced glycation end products induce expression of vascular endothelial growth factor by retinal Muller cells. Biochem Biophys Res Commun 236:712–715
Jalkh A, Takahashi M, Topilow HW et al (1982) Prognostic value of vitreous findings in diabetic retinopathy. Arch Ophthalmol 100:432–434
Kishi S, Shimizu K (1993) Clinical manifestations of posterior precortical vitreous pocket in proliferative diabetic retinopathy. Ophthalmology 100:225–229
Kroll P, Wiegand W, Schmidt J (1999) Vitreopapillary traction in proliferative diabetic vitreoretinopathy. Br J Ophthalmol 83:261–264
Milibak T (1997) Cellular infiltration of Cloquet’s canal. Br J Ophthalmol 81:802
Peyman GA, Cheema R, Conway MD et al (2000) Triamcinolone acetonide as an aid to visualization of the vitreous and the posterior hyaloid during pars plana vitrectomy. Retina 20:554–555
Sakamoto T, Fujiisawa K, Kinukawa N et al (2002) Re-worsening factor after successful vitrectomy for diabetic retinopathy: optic disc fibrovascular proliferation and macular disease. Ophthalmologica 216:101–107
Sakamoto T, Miyazaki M, Hisatomi T et al (2002) Triamcinolone-assisted pars plana vitrectomy improves the surgical procedures and decreases the post-operative blood-ocular barrier breakdown. Graefes Arch Clin Exp Ophthalmol 240:423–429
Sebag J (1987) Age-related changes in human vitreous structure. Graefes Arch Clin Exp Ophthalmol 225:89–93
Sebag J (1992) Anatomy and pathology of the vitreo-retinal interface. Eye 6:541–552
Sebag J (1997) Classifying posterior vitreous detachment: a new way to look at the invisible. Br J Ophthalmol 81:521–522
Sebag J (2002) Imaging vitreous. Eye 16:429–439
Sebag J, Buckingham B, Charles MA et al (1992) Biochemical abnormalities in vitreous of humans with proliferative diabetic retinopathy. Arch Ophthalmol 110:1472–1476
Sonoda KH, Ueno A, Enaida H et al (2003) Pars plana vitrectomy assisted by triamcinolone acetonide for refractory uveitis: a case series study. Br J Ophthalmol 87:1010–1014
Sonoda KH, Sakamoto T, Enaida H et al (2004) Residual vitreous cortex after surgical posterior vitreous separation visualized by intravitreous triamcinolone acetonide. Ophthalmology 111:226–230
Takahashi M, Trempe CL, Maguire K et al (1981) Vitreoretinal relationship in diabetic retinopathy. A biomicroscopic evaluation. Arch Ophthalmol 99:241–245
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Yamakiri, K., Yamashita, T., Miyazaki, M. et al. Fibrous proliferation of the pre-papillary canal in proliferative diabetic retinopathy: Cloquet’s canal as a scaffold for proliferative diabetic retinopathy. Graefe's Arch Clin Exp Ophthalmol 243, 204–209 (2005). https://doi.org/10.1007/s00417-004-1001-0
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00417-004-1001-0