diabetic retinopathy

Question 1

what is diabettic retinopthay

Answer 1

multifocal disease of the retinal vasuclauature

Question 2

why does diabtetic retinopahty cause vision loss

Answer 2

the fovea may be involved

over time causes widespread abnormalities of the retina

these have major consequcences which may evetually include virteous hamehorhrages and retinal dettacment

Question 3

what are the different classifications of diabetic retinopathy

Answer 3

background/ preproliferative

preproliferative

profierative

Question 4

features of diabetic retinpathy

Answer 4

microanyrusms

haemhorrhages

microinfarcts

extramacular retinal thickening

odema (exudates)

normal visiionw

Question 5

what are exudates

Answer 5

depostion of lipid and liporotein in the outer plexiform layer in the presence of retinal odema

Question 6

when is an exudate sight threatning

Answer 6

when it falls within the macular

sight threatining maucolpathy

Question 7

what are the causes of vision loss in diabetic maculpathy

Answer 7

macular odema

foveal iscahemia

foveal hamehorrhage (often ischameic)

Question 8

what are the treatments for diabetic maculopathy

Answer 8

macular grid or modified grid (focal or laser)

intravirteal tricamoline

Question 9

what are the features of pre proliferative diabettic retinopathy

Answer 9

blot retinal haemhorrhages

intraretinal microvascualr

abormalities

venous dilation

venous beading

venous loops

microinfarcts

retinal vasuclar sheathing

Question 10

treatment for macular odema

Answer 10

laser treatment

Question 11

if pt dosnt respond to laser treatment for macular odema

Answer 11

anti VEGF injections

Question 12

what are features of background DR

Answer 12

microanyerusms

haemhorrhages

microinfarcts

extramacular retinal thickening

odema excudates , normal vision

Question 13

features of diabetic maculopathy

Answer 13

exudates in the macula

exudate+ retinal thickening near foveals

red dots- hamehorrhages + micraneuurysm

Question 14

features of pre - proliferative DR

Answer 14

venous loop/bead/dilaition

blood retinal haemhorrhage

microinfarcts

vascular sheathing

Question 15

management of preproliferative DR

Answer 15

PRP

Question 16

Features of proliferative diabetic retinopathy

Answer 16

Neovascularisation at the optic disc

Question 17

features of advanced DR

Answer 17

gel hamehorhhage / hamehorrhage / NVE /NVD

pre- retimal heamhorrhage

Question 18

risk factors for diabetic retinopathy

Answer 18

poor control of blood sugar

poor control of blood pressure

raised serum lipids

smoking

pregnancy

Question 19

what is diabetic retinopathy

Answer 19

disease of retinal microvasculature

clinical features: due to multiple areas of focal abnormality in small retinal vessels

Question 20

what is background retinoptathy (features)

Answer 20

background (non sight threatening retinopathy)

microanyerusms

haemorrhages

microinfarcts

extramacular retinal (odema)

exudates

normal vision

Question 21

what are the consequences of diabetic retinopathy

Answer 21

visual loss because fovea may be involved

Question 22

what do haemoharrhages and microinfarcts look like on the fovea

Answer 22

haemhorrhages - tiny red dots

microinfarcts - really small yellow

Question 23

what are microinfarcts

Answer 23

interrupted axoplasmic flow at site of microvascular occlusion , small area of perfusion , therefore generalised low perfusion in diabetic retinopathy

Question 24

what are exudates

Answer 24

deposition of lipid protein in the presence of retinal oedema

Question 25

what are possible features of background retina

Answer 25

drusen (holes in the retina)

Question 26

what is the management of diabetic retinopahty

Answer 26

none for retinopathy (not sight threatening ) annual review

Question 27

features associated with proliferative diabetic retinpathy

Answer 27

neovascularisation most important reason for poor outcome (blindness) is inadequate laser 1st priority is to undertake pan retinal photocoagulation

Question 28

describe the pathogenesis of diabetic retinopathy

Answer 28

microvascular changes lead to increased leakage of the capillary cells wall , damage to leads to development of microanyerusms increased leakage of lipids causes hard exudate deposits capillaries can break up causing dot and blot haemorrhages capillary occlusion leads to hypoxia = cotton wool spots and stimulate neovasuclairation macular leakage and oedema can affect vision

Question 29

features of non proliferative diabetic retinopathy

Answer 29

anyeurms haemorrhage hard exudates

Question 30

features of proliferative diabetic retinopathy

Answer 30

growth of abnormal blood vessels signs of previous or current macular oedema clinical signs - diabetic macula oedema hard exudates neovascularisation/ virtuous/ pre retinal hamehorrhage

Question 31

what is the classification of non proliferative diabetic retinopathy

Answer 31

background : features microanyerusms , dot and blood haemorrhages hard exudates pre- proliferative : cotton wool spots IRMAs

Question 32

what are the features of a proliferative disc

Answer 32

neovascualrisation elsewhere in the retina

Question 33

features of diabetic maculopathy

Answer 33

grouped exudate within the macula treatment is focal laser oct is used to measure retinal macular thickness is circulate exudate falls within the circle defining the retina then classified as a sight threatening maculopathy

Question 34

what are the causes of vision loss in diabetic retinopathy

Answer 34

macular oedema foveal ischameia ] foveal hamehorrhage

Question 35

how is visual loss investigated

Answer 35

OCT fluroscein angiography ensure VA loss is not refractive

Question 36

fetaures od preproliferative diabetic retinopthay

Answer 36

blot retinal haemorrhages - dark red spots , indicates non perfusion venous dilation venous beading microinfarcts intraneutral microvascular