Histopathology and regression of retinal hard exudates in diabetic retinopathy after reduction of elevated serum lipid levels

M Cusick, EY Chew, CC Chan, HS Kruth, RP Murphy… - Ophthalmology, 2003 - Elsevier
M Cusick, EY Chew, CC Chan, HS Kruth, RP Murphy, FL Ferris III
Ophthalmology, 2003Elsevier
PURPOSE: To describe a regression of retinal hard exudates in 2 patients with diabetic
maculopathy, and to report immunohistologic findings reflecting lipid deposition in the retina.
DESIGN: Two interventional case reports. METHODS: Two patients with exudative diabetic
maculopathy were treated to normalize serum lipids. Histologic examination and
immunohistochemistry of each patient's eyes were performed to assess the localization of
apolipoprotein B and cholesteryl ester, both of which are principal components of low …
PURPOSE
To describe a regression of retinal hard exudates in 2 patients with diabetic maculopathy, and to report immunohistologic findings reflecting lipid deposition in the retina.
DESIGN
Two interventional case reports.
METHODS
Two patients with exudative diabetic maculopathy were treated to normalize serum lipids. Histologic examination and immunohistochemistry of each patient's eyes were performed to assess the localization of apolipoprotein B and cholesteryl ester, both of which are principal components of low-density lipoprotein.
RESULTS
Both patients showed a dramatic regression of retinal hard exudates after correction of dyslipidemia. Histopathology revealed diffuse lipids and cholesteryl ester in the retina. Apolipoprotein B and macrophages were colocalized in the perivascular space.
CONCLUSIONS
The regression of hard exudates was most likely due to the aggressive lipid lowering in both patients. The novel histopathologic findings of hard exudate and diabetic maculopathy are similar to the pathologic changes observed in larger atherosclerotic lesions, except that they occur in the intraretinal perivascular space.
Elsevier