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Jonas S. Friedenwald, M.D.
JAMA. 1952;150(10):969-971. doi:10.1001/jama.1952.03680100011004.
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Diabetic retinopathy is characterized by the presence of small, sharply outlined "petechiae" and hard white "exudates" in the retina, usually most concentrated in the posterior pole of the eyeground. Repeated photographing of the fundus shows that the same "petechia" may persist at the same spot for many months. Since small hemorrhages in the retinal tissue in other diseases are regularly absorbed in a few days, it follows that "petechiae" of the diabetic must be enclosed in some protective covering. Nettleship,1 in 1877, noted the presence of sacular capillary aneurysms in diabetic retinopathy, but little attention was paid to this early observation. The retinal capillary aneurysms of the diabetic were rediscovered by Ballantyne and Loewenstein2 in 1943. In recent years, knowledge of retinal vascular pathological conditions has been greatly advanced by the study of flat preparations of the whole retina2 and the visualization of the whole retinal vascular


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