Diabetic Retinopathy Flashcards
What causes diabetic retinopathy
Chronic progressive diabetic microvascular leakage and occlusion
Pathophysiology of diabetic retinopathy
Hyperglycaemia impairs blood flow and therefore damages blood vessel walls. Retinal capillary leakage gives rise to intraretinal haemorrhage, cholesterol exudate deposition and retinal oedema.
When the macular area of the retina is involved, central vision will be impaired.
Difference between non proliferative and proliferative diabetic retinopathy
NPDR is early stages and less severe; the blood vessels may leak fluid into the eye causing blurred vision.
PDR is progressed and more severe. There is neovascularisation these vessels are fragile and can haemorrhage
Epidemiology of diabetic retinopathy
People with diabetes are most likely to develop diabetic retinopathy than other complications.
Mild non proliferative diabetic retinopathy findings on Opthalmoscopy
Micro aneurysms only
Moderate non proliferative diabetic retinopathy findings on ophthalmoscopy
Microaneurysms, retinal dot and blot haemorrhages, hard exudates or cotton wool spots
Severe non proliferative diabetic retinopathy findings on ophthalmoscopy
Intraretinal haemorrhages, intraretinal microvascular abnormalities
Proliferative diabetic retinopathy findings on ophthalmoscopy
Neovascularisation or preretinal haemorrhages
Common findings in diabetic retinopathy
Micro-aneurysms, cotton wool spots, lipid exudates, floaters, intraretinal haemorrhage, macular thickening
Risk factors for diabetic retinopathy
Hyperglycaemia for a long time, hypertension, renal disease, poor glycemic control
Investigations
Photographs of fundus
Treatment for diabetic retinopathy (NPDR)
Anti VEGF therapy (anti vascular endothelial growth factor)
Pan retinal photocoagulation
Macular laser therapy
How to treat proliferative diabetic retinopathy ( PDR)
Vitrectomy
Prognosis of diabetic retinopathy
Chronic and progressive.