Diabeetic Retinopathy Flashcards
Non-proliferative Diabetic Retinopathy
retinal vessels are weakened
microaneurysms
macular edema
Proliferative Diabetic Retinopathy
retina deprived of oxygen
neovascularization of retina and vitreous, can leak fluid
Ocular Problems Associated with Diabeetus
diabetic retinopathy refractive changes cataracts glaucoma EOM palsies
Ethnicities most likely to be diabetic
African Americans
Mexicans
Leading cause of new cases of blindness in adult
diabetic retinopathy
Risk Factors for Diabetic Retinopathy
duration of DM poor control of blood glucose levels hypertension pregnancy race kidney disease smoking, obesity, high cholesterol
Initial Symptoms of Diabetic Retinopathy
floaters
blurred vision
distortion
diplopia
1st Clinical Sign of Diabetic Retinopathy
microaneurysms
Signs of NPDR
microaneurysms retinal hemorrhages and edema exudates cotton wool spots venous changes IRMA macular ischemia
Signs of PDR
neovascularization- NVD, NVE, NVI, NVG
preretinal and vitreous hemorrhages
fibrovascular tissue proliferation
Imaging to show DR
fluorescein angiography
OCT
B-scan ultrasound
Managing Diabetic Retinopathy
education ensure systemic management reinforce need for compliance monitor changes low vision rehab
Prevention of DR
Take meds Reach and maintain healthy weight Add physical activity Control ABCs- A1C, BP, cholesterol Kick smoking habit
Treating Macular Edema
focal or grid laser
anti-VEGF injection
pars plana vitrectomy
Anti-VEGF
blocks vascular endothelial growth factor, stopping abnormal vessel growth
Treatment for Proliferative Diabetic Retinopathy
panretinal photocoagulation- laser over whole retina except macula
anti-VEGF
SE of Panretinal Photocoagulation
loss of peripheral vision
trouble with night vision
Treating Vitreous and Preretinal Hemorrhages
vitrectomy for hemes that don’t resolve in 6 mo
anti-VEGF
Treating Retinal Detachment
surgery if close to macula
watch others
Treating Iris Neovascularization
anti-VEGF
Follow up No DR
12 months
Follow up very mild NPDR
12 months
Follow up Microaneurysms only
12 months
Follow up Mild NPDR
any microaneurysms, hemes, exudates, cotton wool spots, no IRMA
6-12 months, depending on severity of signs, systemic factors
Follow up Moderate NPDR
severe hemes, significant venous beading in only 1 quadrant, many cotton wool spots
6 months
Follow up Severe NPDR
4 months
4-2-1 Rule
Severe NPDR
diffuse retinal hemorrhages in 4 quadrants
venous beading in 2
IRMA in 1
Follow up Very Severe NPDR
2-3 months
Follow up Mild- Moderate PDR
NVD, NVE
treatment
2 months if no treatment started
Follow up High Risk PDR
NVD greater than 1/3 of disc
NVE greater than 1/2 disc with vitreous hemorrhage
treatment
