PRE-PROLIFERATIVE
retinopathy consists of any or all of the changes of background diabetic
retinopathy with the addition of significant venous beading, cotton wool
spots, extensive formation of IRMA, extensive ischemia.
1.
Significant venous beading --Initially, venules may show focal
areas of dilation which may progress to significant venous beading and
formation of venous loops as the diabetic retinopathy progresses.
2.
Cotton wool spots (cytoid bodies or soft exudates) --Actually not
an exudate, but produced by clusters of focal ischemic infarcts in nerve
fiber layer
(#22041).
Histologically, cytoid bodies which are clusters of degenerated and
swollen ganglion cells axons which resemble round or fusiform cells are
seen(#22042).
3.
Intraretinal microvascular abnormalities (IRMA).
--To compensate for hypoxic conditions, non-leaking intraretinal
vascular shunts may develop (IRMA). These
indicate a progression toward the pre-proliferative phase.
4.
Extensive retinal ischemia
(#22781,
#22784, #22787, #22880) are additional slides of cotton wool spots (cytoid
bodies).
