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Biomicroscopy versus fluorescein angiography of the iris in the detection of diabetic iridopathy

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Abstract

Iris fluorescein angiography is not commonly employed in clinical practice, but it is the most sensitive technique for the evaluation of iris vessel abnormalities. We used iris fluorescein angiography as the gold standard against which to test the ability of iris biomicroscopy to demonstrate diabetic iridopathy (DI). One hundred and fourteen eyes of 63 diabetic patients affected by preproliferative or proliferative diabetic retinopathy (DR) (the DR groups at high risk of developing DI) were considered. The DI fluorangiographic classification used was: (1) absence of DI; (2) nonproliferative DI; (3) proliferative DI. The sensitivity of biomicroscopy in detecting DI turned out to be 57%, while the specificity was 94%. The positive predictive value was 93% and the negative predictive value 50%. Our study proved that biomicroscopy can accurately judge when DI is absent. When it is present, however, there is a high probability that biomicroscopy will be less precise in the detection of iris lesions.

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References

  1. Aiello LM, Wand M, Liang G (1983) Neovascular glaucoma and vitreous haemorrhage following cataract surgery in patients with diabetes mellitus. Ophthalmology 90:814–819

    PubMed  Google Scholar 

  2. Algvere P, Kornacki B (1978) Fluorescein angiography of the iris: a correlation of microangiopathy in the iris and retina. Acta Ophthalmol 56:803–816

    Google Scholar 

  3. Apple DJ (1981) Pathology. In: L'Esperance FA, James WA (eds) Diabetic retinopathy. Clinical evaluation and management. Mosby, St Louis, pp 38–57

    Google Scholar 

  4. Apple DJ, Craythorn JM, Oison RJ, Little LE, Lyman JB, Reidy JJ, et al (1984) Anterior segment complications and neovascular glaucoma following implantation of a posterior chamber intraocular lens. Ophthalmology 91:403–419

    PubMed  Google Scholar 

  5. Baggesen LH (1969) Fluorescein angiography of the iris in diabetics and non-diabetics. Acta Ophthalmol 47:449–460

    Google Scholar 

  6. Blankenship GW (1980) Preoperative iris rubeosis and diabetic vitrectomy results. Ophthalmology 87:176–182

    PubMed  Google Scholar 

  7. Blankenship GW, Machemer R (1978) Pars plana vitrectomy for the managment of severe diabetic retinopathy: an analysis of results five years following surgery. Ophthalmology 85:553–559

    PubMed  Google Scholar 

  8. Blankenship GW, Machemer R (1985) Long-term diabetic vitrectomy results: report of 10 years follow-up. Ophthalmology 92:503–506

    PubMed  Google Scholar 

  9. Bonnet M, Jourdain M, Francoz-Taillanter N (1981) Correlation neovaisseaux papillaires-rubeosis iridis. J Fr Ophtalmol 4:405–410

    PubMed  Google Scholar 

  10. Brancato R, Menchini U, Carnevalini A (1981) Atlante di iridografia a fluorescenza. C.I.C. Ed Int Gruppo Ed Medico, Roma, p 11

    Google Scholar 

  11. Brancato R, Menchini U, Carnevalini A (1981) Atlante di iridografia a fluorescenza. C.I.C. Ed Int Gruppo Ed Medico, Roma, p 13

    Google Scholar 

  12. Brancato R, Menchini U, Carnevalini A, Capoferri C (1985) Rubeosis iridis et réinopathie diabétique. In: Coscas G (ed) La rétinopathie diabétique. Proc Symposium International sur la Rétinopathie Diabétique; 1984; Paris. Rev Int Chibret Ophtalmol 105:287–294

  13. Brancato R, Bandello F, Carnevalini A, Camesasca F, Meloni P (1987) Intraocular lens and diabetes. In: Maumenee AE, Stark WJ, Esente I (eds) Cataract and refractive microsurgery. Proc of the IV International Congress, Florence (Italy), 1987, Fogliazza, Milano, pp 133–139

  14. Brancato R, Leoni G, Trabucchi G, Lakidi E, Bulloni M (1989) Contact transscleral irradiation of human chorioretina with continuous-wave Nd:YAG laser. Ophthalmic Res 21:1–7

    PubMed  Google Scholar 

  15. Cunliffe IA, Flanagan DW, George NDL, Aggarwaal RJ, Moore AT (1991) Extracapsular cataract surgery with lens implantation in diabetics with and without proliferative retinopathy. Br J Ophthalmol 75:9–12

    PubMed  Google Scholar 

  16. Demeter V, Sautter H (1978) Irisangiographische untersuchungen bei patienten mit diabetes mellitus. Adv Ophthalmol 36:233–244

    PubMed  Google Scholar 

  17. Ehrenberg M, Brooks W, McCuen II, Schindler RH, Machemer R (1984) Rubeosis iridis: preoperative iris fluorescein angiography and periocular steroids. Ophthalmology 91:321–325

    PubMed  Google Scholar 

  18. Eichenbaum DM (1977) Iris neovascularization after pars plana vitrectomy. In: Freeman HM, Hirose T, Schepens CL (eds) Vitreous surgery and advances in fundus diagnosis and treatment. Appleton Century Crofts, New York, p 373

    Google Scholar 

  19. Friedburg D (1973) Fluoreszenzangiographie der Iris bei Diabetiken. Klin Monatsbl Augenheilkd 162:218–223

    PubMed  Google Scholar 

  20. Gartner S, Henkind P (1978) Neovascularization of the iris (rubeosis iridis). Surv Ophthalmol 22:291–312

    PubMed  Google Scholar 

  21. Jensen VA, Lundbaek K (1968) Fluorescence angiography of the iris in recent and long term diabetes. Diabetologia 4:161–163

    PubMed  Google Scholar 

  22. Kottow M (1979) Fundamentals of angiographic interpretation: the normal anterior segment fluorescein angiogram. In: Kottow M Anterior segment fluorescein angiography. Williams & Wilkins, Baltimore, p 51

    Google Scholar 

  23. Kottow M (1979) Fundamentals of angiographic interpretation: the abnormal anterior segment fluorescein angiogram. In: Kottow M Anterior segment fluorescein angiography. Williams & Wilkins, Baltimore, pp 56–76

    Google Scholar 

  24. Kottow M (1979) Diabetic microangiopathy. In: Kottow M Anterior segment fluorescein angiography. Williams & Wilkins, Baltimore, pp 153–176

    Google Scholar 

  25. Laatikainen L (1979) Development and classification of rubeosis iridis in diabetic eye disease. Br J Ophthalmol 63:150–156

    PubMed  Google Scholar 

  26. Levin ML, Kincaid MC, Eifler CW, Holt JE, Speight JW, O'Connor PS (1988) Effect of cataract surgery and intraocular lenses on diabetic retinopathy. J Cataract Refract Surg 14:642–649

    PubMed  Google Scholar 

  27. Lewis ML (1981) Iris fluorescein angiography. Dev Ophthalmol 2:282–285

    PubMed  Google Scholar 

  28. Pavese T, Insler MS (1987) Effects of extracapsular cataract extraction with posterior chamber lens implantation on the development of neovascular glaucoma in diabetics. J Cataract Refract Surg 13:197–201

    PubMed  Google Scholar 

  29. Poliner LS, Christianson DJ, Escoffery RF, Kolker AE, Cordon ME (1985) Neovascular glaucoma after intracapsular and extracapsular cataract extraction in diabetic patients. Am J Ophthalmol 100:637–643

    PubMed  Google Scholar 

  30. Pollack A, Dotan S, Oliver M (1991) The course of diabetic retinopathy following cataract surgery. Br J Ophthalmol 75:28

    PubMed  Google Scholar 

  31. Pollack A, Dotan S, Oliver M (1991) Progression of diabetic retinopathy after cataract extraction. Br J Ophthalmol 75:547–551

    PubMed  Google Scholar 

  32. Prasad P, Setna PH, Dunne JA (1990) Accelerated ocular neovascularization in diabetics following posterior chamber lens implantation. Br J Ophthalmol 74:313–314

    PubMed  Google Scholar 

  33. Rice TA, Michels RG, Maguire MG, Rice EF (1983) The effects of lensectomy on the incidence of iris neovascularization and neovascular glaucoma after vitrectomy for diabetic retinopathy. Am J Ophthalmol 95:1–11

    PubMed  Google Scholar 

  34. Rosenthal AR (1983) The diagnosis and management of rubeosis iridis. In: Little HL, Patz A, Jack RL, Forsham PH (eds) Diabetic retinopathy. Thieme-Stratton, New York, pp 351–360

    Google Scholar 

  35. Ruiz TS, Saatei OA (1991) Posterior chamber intraocular lens implantation in eyes with inactive and active proliferative diabetic retinopathy. Am J Ophthalmol 111:158–162

    PubMed  Google Scholar 

  36. Sebestyen JG (1986) Intraocular lenses and diabetes mellitus. Am J Ophthalmol 101:425–428

    PubMed  Google Scholar 

  37. Vannas A (1969) Fluorescein angiography of the vessels of the iris in pseudoexfoliation of the lens capsule, capsular glaucoma and some other forms of glaucoma. Acta Ophthalmol (Copenh) [Suppl] 105:1–75

    Google Scholar 

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Bandello, F., Brancato, R., Lattanzio, R. et al. Biomicroscopy versus fluorescein angiography of the iris in the detection of diabetic iridopathy. Graefe's Arch Clin Exp Ophthalmol 231, 444–448 (1993). https://doi.org/10.1007/BF02044229

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  • DOI: https://doi.org/10.1007/BF02044229

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