6.1.10 Flashcards
What is diabetic retinopathy (DR)?
A condition classified into different stages based on severity, affecting the retina in diabetes.
The grading system is based on clinical signs and helps determine referral urgency and treatment.
What are the key clinical signs of Background Diabetic Retinopathy (Non-Proliferative Diabetic Retinopathy - NPDR)?
- Microaneurysms
- Dot-and-blot haemorrhages
- Hard exudates
- Cotton wool spots
These signs indicate varying degrees of retinal damage.
What characterizes Mild NPDR?
Microaneurysms and a few scattered hemorrhages without significant vision loss.
This is the least severe stage of NPDR.
What is the referral recommendation for Severe NPDR?
Requires urgent referral to secondary care.
This is crucial to prevent further vision problems.
What are the key clinical signs of Diabetic Maculopathy?
- Macular edema
- Cystoid macular edema (CME)
Both conditions impact central vision significantly.
What defines Clinically Significant Macular Edema (CSME)?
Macular edema affecting the center of the macula, with swelling within 500 microns of the fovea or hard exudates near the fovea.
CSME can severely impact vision.
What is the urgency of referral for CSME?
Requires urgent referral within 2 weeks for possible laser treatment or anti-VEGF treatment.
Timely intervention is critical to prevent vision loss.
What are the key clinical signs of Pre-Proliferative Diabetic Retinopathy (Pre-PR)?
- Extensive retinal hemorrhages
- Cotton wool spots
- Venous beading
- Intraretinal microvascular abnormalities (IRMA)
- Retinal ischemia
These signs indicate a risk of progression to more severe stages.
What is the referral recommendation for Pre-Proliferative Diabetic Retinopathy?
Urgent referral to secondary care within 1-2 weeks.
Monitoring is essential to prevent progression.
What are the key clinical signs of Proliferative Diabetic Retinopathy (PDR)?
- Neovascularization
- Vitreous hemorrhage
- Fibrous tissue formation
These signs indicate advanced retinal damage.
What is the urgency of referral for Proliferative Diabetic Retinopathy?
Immediate referral to hospital eye services within 24-48 hours.
Urgent intervention is necessary to prevent vision loss.
What are the treatment options for Diabetic Retinopathy?
- Laser Photocoagulation
- Anti-VEGF Injections
- Vitrectomy Surgery
Each treatment option addresses different aspects of diabetic retinopathy.
How is Laser Photocoagulation explained to patients?
A treatment using a laser to seal leaking blood vessels or stop the growth of new ones.
It is analogous to fixing a tear in a pipe.
What is the purpose of Anti-VEGF Injections?
To stop the growth of abnormal blood vessels and reduce swelling in the eye.
This can improve vision.
What does Vitrectomy Surgery involve?
Removing blood and scar tissue from the eye to allow better light access to the retina.
It is a more serious procedure aimed at preventing further vision damage.
True or False: Mild NPDR requires urgent referral.
False
Mild NPDR typically does not require urgent referral but should be monitored.
Fill in the blank: The grading system for Background Diabetic Retinopathy includes _____, Moderate NPDR, and Severe NPDR.
Mild NPDR
These stages reflect the increasing severity of retinal damage.
What is the key clinical sign of Cystoid Macular Edema (CME)?
Fluid leakage causing cyst-like changes in the macula.
This condition leads to distorted vision.
What are microaneurysms?
Small, localized dilations of retinal capillaries and the earliest sign of diabetic retinopathy
They indicate weakened blood vessel walls and can lead to further complications like edema.
How do microaneurysms appear in the retina?
As tiny red dots, often located in the peripheral areas of the retina.
What are the two main types of retinal hemorrhages?
- Dot-and-Blot Hemorrhages
- Flame-Shaped Hemorrhages
What are dot-and-blot hemorrhages?
Small, round hemorrhages typically found in the inner layers of the retina.
What are flame-shaped hemorrhages?
Elongated hemorrhages resembling flames, found in the outer retinal layers.
What do hard exudates indicate in diabetic eye disease?
Long-standing leakage from blood vessels and significant fluid build-up in the retina.
What do hard exudates look like?
Bright yellow spots with well-defined edges.
What are cotton wool spots?
Areas of retinal ischemia caused by blockages in small blood vessels supplying the retina.
How do cotton wool spots appear?
Fluffy, white lesions in the retina, often located in the posterior pole.
What does venous beading indicate?
Severe retinal damage and significant stress on the retinal blood supply.
How does venous beading appear in the retina?
As bead-like enlargements along the retinal veins.
What are intraretinal microvascular abnormalities (IRMA)?
Growth of abnormal blood vessels within the retina, often a precursor to neovascularization.
What does IRMA indicate?
Increased risk for the development of proliferative diabetic retinopathy.
What is neovascularization?
Growth of new, abnormal blood vessels on the retina or optic disc in response to ischemia.
What clinical complications can arise from neovascularization?
- Vitreous hemorrhage
- Retinal detachment
- Blindness
What is vitreous hemorrhage?
Bleeding into the vitreous gel of the eye from abnormal blood vessels in the retina.
What symptoms may indicate vitreous hemorrhage?
- Sudden loss of vision
- Floating spots
- Blurry vision
What is retinal detachment?
Separation of the retina from the back of the eye, often due to contraction of scar tissue or new blood vessels.
What are the signs of retinal detachment?
- Areas of elevated retina
- Sudden flashes of light
- Vision loss
What is the referral guideline for mild to moderate NPDR?
Regular monitoring every 6-12 months unless vision is affected or signs of progression are present.
When should urgent referral be made for clinically significant macular edema (CSME)?
Within 2 weeks for potential laser treatment or anti-VEGF injections.
What is the urgent referral timeframe for pre-proliferative diabetic retinopathy?
Within 1-2 weeks to prevent progression to proliferative retinopathy.
What is the immediate referral timeframe for proliferative diabetic retinopathy (PDR)?
Within 24-48 hours for possible laser photocoagulation, anti-VEGF injections, or vitrectomy surgery.
