TO THE QUESTION OF NECESSITY OF CREATING A NEW CLASSIFICATION OF PROLIFERATIVE DIABETIC RETINOPATHY

Abstract

At present, there are significant difficulties in systematizing the results of studies of angiogenesis in diabetic retinopathy (DR), due to the lack of a classification reflecting the options for the development of this process.The work aimed to elaborate a classification of the stages of development of pathological angiogenesis in diabetic retinopathy.The basis of this study is the analysis of the results of monitoring the course of diabetic retinal lesions in patients of the department of vitreoretinal pathology of the Research Institute of Eye Diseases and the Ophthalmology Department of the 52nd City Clinical Hospital in Moscow from 1993 to the present.An important feature of DR, which, from our point of view, must be taken into account, is the reversibility of the retinal vascular lesion in diabetes at all stages, including proliferative. A stable remission of diabetic retinopathy can occur after treatment (panretinal laser coagulation of the retina or vitrectomy); and also it can arise "spontaneously" - in the absence of therapeutic measures taken in ophthalmic practice. In connection with the possibility of the onset of remission at different stages of angiogenesis, it is impossible to make a correct clinical and pathomorphological study without considering the stage of development in each case. In assessing the risk factors for the progression of DR, one must take into account that its evolution can occur in two ways: as a phase of development and a phase of regression. We considered expedient to subdivide each of these phases into stages. In the first case, the study makes it possible to study the stages of development of angiogenesis and the features of the structure of neovessels on each of them, in the second - the stages of its involution. The suggested classification seems convenient for ascertaining both clinical and pathomorphological stages of the evolution of the newly formed tissue. Each stage has a short designation and a clear decoding.