Diabetic Retinopathy Flashcards
What is diabetic retinopathy
a progressive ophthalmic microvascular complication of diabetes
What is the primary cause of diabetic retinopathy
chronic hyperglycaemia
What are the main hypothesis for the pathogenesis of diabetic retinopathy
impaired autoregulaiton of retinal blood flow
accumulation of sorbitol within the retinal cells
accumulation of advanced glycosylation end products in the extracellular fluid
What is the main symptom of diabetic retinopathy
Usually no symptoms until the late stages
What are the various identifiable stages of diabetic retinopathy
background retinopathy
preproliferative retinopathy
proliferative retinopathy
Cotton wool spots are a feature of what
preproliferative retinopathy
What are features of background retinopathy
microaneurysms
retinal haemorrhages
hard exudes
What are features of proliferative retinopathy
new vessels on disc
new vessels elsewhere pre retinal or virtuous haemorrhage
What can result in small flame-shaped and blot haemorrhages
The intraluminal proliferation of cells, as well as changes in platelet function, erythrocyte aggregation and high plasma fibrinogen levels can cause vascular occlusion and rupture
What does progressive neurovascular occlusion and retinal ischaemia result in
an increased release of vasoproliferativhe substances such as IGF-1 and VEFG which promote the formation of new vessels
What are the two main risks associated with new vessel formation
pre-retinal or vitrosu haemorrhage: the new vessels are fragile and therefore more prone to rupture
Retinal detachment: as new vessels mature, the fibrous component becomes more prominent resulting in contraction
What happens is new vessel proliferation occurs in the anterior chamber
glaucoma by blocking the outflow of the aqueous humour
What is maculopathy characterised by
exudates of retinal thickening within one disc diameter of the centre of the fovea
What is macular oedema characterised by
retinal thickening due to leaky blood vessels and can develop t any stage of retinopathy
What is treatment of diabetic retinopathy directed at
both reducing the risk and progression of retinopathy and at the treatment of established disease
