Diabetic Retinopathy

Question 1

Diabetic retinopathy is the most common cause of blindness in adults between what age group?

Answer 1

35-65 years old

Question 2

What are the 2 broad categories of diabetic retinopathy?

Answer 2

• Non-proliferative
• Proliferative

Question 3

Non-Proliferative Diabetic Retinopathy (NPDR) is divided into 3 categories. Describe these categories.

Answer 3

• Mild - 1 or microaneurysms
• Moderate
  
  • microaneurysms.
  • Blot haemorrhages
  • Hard exudates
  • Cotton wool spots
  • Venous beading.
• Severe - moderate features but more widely spread on the retina.

Question 4

What is a main feature of proliferative retinopathy and what can it lead to?

Answer 4

Retinal neovascularisation

It can lead to vitrous haemorrhage

Question 5

What type of diabetic is more likely to get proliferative retinopathy?

Answer 5

Type 1

50% more likely

Question 6

What are T2DM more likely to get?

Answer 6

Maculopathy

Hard exudates and other bakground changes on the macula.

Question 7

A 54-year-old man with type 2 diabetes mellitus is found on annual review to have new vessel formation at the optic disc. Visual acuity in both eyes is not affected (6/9). Blood pressure is155/84 mmHg.

HbA1c 8.4%

What is the most important intervention in this patient?

• Follow-up opthalmosocopy in 3 months
• Add aspirin
• Blood pressure control
• Tight glycemic control
• Laser therapy

Answer 7

Laser therapy

The patient has proliferative diabetic retinopathy and an urgent referral to opthalmology is required for panretinal photocoagulation.