Other American studies fail to confirm an association

ED1TOR,-We agree with Helen Ward and John S Yudkin that diabetic retinopathy should not be a contraindication to the use of thrombolysis in myocardial infarction.'In September 1991 one of us (RCW) expressed concern locally that the practical difficulty of excluding diabetic retino- pathy could easily lead to diabetic patients being denied thrombolysis.The need for a rapid decision, often without the benefit of case notes and after opiate analgesia, posed particular problems for the receiving team.Subsequently, discussion took place in Mersey region among diabetologists, ophthalmologists, and cardiologists in their respective subcommittees of the regional medical committee.It was agreed that diabetic retinopathy should no longer be regarded as a contraindication to thrombolysis for two reasons: firstly, the potential benefits of a