Diabetic retinopathy

Question 1

R0

Answer 1

No retinopathy

Question 2

R1

Answer 2

mild non proliferative

• microaneurysms
• haemorrhages

Question 3

R2

Answer 3

moderate/ severe non poliferative

• exudates
• cotton wool spots
• venous bleeding
• microvascular abnormalities

Question 4

R3

Answer 4

retinal neovascularisation

Question 5

m0

Answer 5

no maculopathy

Question 6

m1

Answer 6

diabetic maculopathy

Question 7

At what stage is an ophthalmologist involved?

Answer 7

R2 / M1

Question 8

Lifestyle treatment

Answer 8

Reduce BP
Reduce blood lipid levels
Bring down HbA1C slowly

Question 9

Treatment for proliferative DR

Answer 9

Panretinal photocoagulation

Question 10

Role of vitrectomy

Answer 10

Treat retinal detachment / macula oedema

Question 11

2 possible end points if DR not treated properly

Answer 11

Tractional retinal detachment

Rubeotic glaucoma

Question 12

Summary of diabetic retinopathy

Answer 12

Retinopathy: summary
 Background- micoraneurysms and hard exudates
 Maculopathy- check acuity; reduction in acuity due either to cataracts or maculopathy
 Pre-proliferative- cotton wool spots (an infarct of the nerve cell layer on surface of
retina); also venous bleeding and looping; intra-retinal microvascular abnormalities
 Proliferative- new vessels
 End-stage- scarring with white bands of scar tissue and retinal traction