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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Aiello LM, Wand M, Liang G (1983) Neovascular glaucoma and vitreous haemorrhage following cataract surgery in patients with diabetes mellitus. Ophthalmology 90:814–819
Algvere P, Kornacki B (1978) Fluorescein angiography of the iris: a correlation of microangiopathy in the iris and retina. Acta Ophthalmol 56:803–816
Apple DJ (1981) Pathology. In: L'Esperance FA, James WA (eds) Diabetic retinopathy. Clinical evaluation and management. Mosby, St Louis, pp 38–57
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
Baggesen LH (1969) Fluorescein angiography of the iris in diabetics and non-diabetics. Acta Ophthalmol 47:449–460
Blankenship GW (1980) Preoperative iris rubeosis and diabetic vitrectomy results. Ophthalmology 87:176–182
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
Blankenship GW, Machemer R (1985) Long-term diabetic vitrectomy results: report of 10 years follow-up. Ophthalmology 92:503–506
Bonnet M, Jourdain M, Francoz-Taillanter N (1981) Correlation neovaisseaux papillaires-rubeosis iridis. J Fr Ophtalmol 4:405–410
Brancato R, Menchini U, Carnevalini A (1981) Atlante di iridografia a fluorescenza. C.I.C. Ed Int Gruppo Ed Medico, Roma, p 11
Brancato R, Menchini U, Carnevalini A (1981) Atlante di iridografia a fluorescenza. C.I.C. Ed Int Gruppo Ed Medico, Roma, p 13
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
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
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
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
Demeter V, Sautter H (1978) Irisangiographische untersuchungen bei patienten mit diabetes mellitus. Adv Ophthalmol 36:233–244
Ehrenberg M, Brooks W, McCuen II, Schindler RH, Machemer R (1984) Rubeosis iridis: preoperative iris fluorescein angiography and periocular steroids. Ophthalmology 91:321–325
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
Friedburg D (1973) Fluoreszenzangiographie der Iris bei Diabetiken. Klin Monatsbl Augenheilkd 162:218–223
Gartner S, Henkind P (1978) Neovascularization of the iris (rubeosis iridis). Surv Ophthalmol 22:291–312
Jensen VA, Lundbaek K (1968) Fluorescence angiography of the iris in recent and long term diabetes. Diabetologia 4:161–163
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
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
Kottow M (1979) Diabetic microangiopathy. In: Kottow M Anterior segment fluorescein angiography. Williams & Wilkins, Baltimore, pp 153–176
Laatikainen L (1979) Development and classification of rubeosis iridis in diabetic eye disease. Br J Ophthalmol 63:150–156
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
Lewis ML (1981) Iris fluorescein angiography. Dev Ophthalmol 2:282–285
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
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
Pollack A, Dotan S, Oliver M (1991) The course of diabetic retinopathy following cataract surgery. Br J Ophthalmol 75:28
Pollack A, Dotan S, Oliver M (1991) Progression of diabetic retinopathy after cataract extraction. Br J Ophthalmol 75:547–551
Prasad P, Setna PH, Dunne JA (1990) Accelerated ocular neovascularization in diabetics following posterior chamber lens implantation. Br J Ophthalmol 74:313–314
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
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
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
Sebestyen JG (1986) Intraocular lenses and diabetes mellitus. Am J Ophthalmol 101:425–428
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
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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