Diabetic Retinopathy

Question 1

Symptoms of diabetic retinopathy

Answer 1

Early: asymptomatic
- central scotoma
- metamorphopsia
- sudden BOV: VH, RD
- floaters: VH

Question 2

DR grading

Answer 2

mild NPDR: microaneurysm only

moderate NPDR: more than microaneurysm but less than severe NPDR

severe NPDR
- more than 20 intraretinal haemorrhage in each 4 quadrant
- venous beading in 2 or more quadrant
- intraretinal microvascular abnormalities in 1 or more quadrant AND no sx of proliferative retinopathy

Proliferative DR: neovascularization, vitreous/ preretinal haemorrhage

ADED: one of the following
- fibrovascular tissue proliferation
- tractional retinal detachment
- dragging of retinal/distortion
- rhegmatogenous retinal detachment

Question 3

Mx of

Severe NPDR
PDR
DME
ADED

Answer 3

Severe NPDR: scattered PRP
PDR: PRP
DME:
- focal/grid laser
- intravitreal steroid injection
- intravitreal anti VEGF
ADED: TPPV (trans pars plana vitrectomy)