Coexistence of localized scotomata and neovascularizations in proliferative diabetic retinopathy

Fifteen eyes of 15 patients with proliferative diabetic retinopathy within the central 60 degrees of the eye fundus were examined with computerized perimetry, and the visual field data were accurately correlated with the corresponding morphology as seen on fundus photographs and fluorescein angiograms. In 12 out of 13 eyes with neovascularizations outside the optic disc area an absolute scotoma could be correlated with a retinal area distal from the neocascularization, and in one case no scotoma was found in this area. The localized scotomata corresponded in 8 cases to non-perfusion areas as seen on fluorescein angiograms, whereas in 5 cases no pathological morphology was detected in these areas. Seven eyes which had neovascularizations at the optic disc showed the same pattern, but with visual field loss of more pronounced degree. Furthermore, other scotomata which not corresponded to any pathological fundus morphology occurred at approx. 30 degrees eccentricity in the visual field. The findings are discussed in relation to the current hypothesis about the initiation and development of neovascularizations in proliferative diabetic retinopathy.