diabetic retinopathy

Question 1

defintion

Answer 1

disease of the retina caused by diabetes

Question 2

diabetic retinopathy

Answer 2

is the commonest cause of new onset blindness in those between 20-65

Question 3

pathophysiology

Answer 3

chronic hyperglycaemia damages the tiny blood vessels in the retina, this can cause the blood vessels to leak fluid or haemorrhage and in its most advances stage can cause new abnormal blood vessels to proliferate on the surface of the retina

Question 4

function of the retina

Answer 4

detects light and converts it to signals sent through the topic nerve

Question 5

retinal haemorrhages described as

Answer 5

dot blot or flame haemorrhages

Question 6

cotton wool spots on retina are

Answer 6

areas of ischaemia

Question 7

hard exudates on retina are

Answer 7

lipid breakdown products

Question 8

IRMA stands for

Answer 8

intra-retinal microvascular abnormalities which means abnormal but patent blood vessels

Question 9

stages of retinopathy

Answer 9

1. mild non-proliferate
2. moderate non-proliferative
3. severe non-proliferative
4. proliferative

Question 10

mild-non proliferative retinopathy is

Answer 10

also known as background retinopathy where on ophthalmoscopy there are mild abnormalities but person has no symptoms

Question 11

maculopathy is

Answer 11

a manifestation of diabetic retinopathy, results in oedema and exudates involving the macula

Question 12

diabetic maculopathy is a

Answer 12

symptomatic manifestation of non-proliferative retinopathy

Question 13

symptoms of maculopathy

Answer 13

blurred vision, decreased acuity, visual distortion

Question 14

maculopathy is the

Answer 14

number one cause of blindness in patients with diabetic retinopathy

Question 15

the macula is the

Answer 15

central area of the retina which provides central vision, in the centre of the macula is the fovea which contains the higher concentration of cones therefore has the clearest vision of all

Question 16

retinopathy and maculopathy are

Answer 16

graded separately

Question 17

retinal grading

Answer 17

R0
R1
R2
R3
R4

Question 18

R0

Answer 18

no diabetic retinopathy

Question 19

management of R0

Answer 19

rescreen in 12 months

Question 20

R1

Answer 20

background diabetic retinopathy, there are no symptoms but one or more of the following is present

• dot haemorrhages
• hard exudates
• blot haemorrhages
• micro aneurysms
• cotton wool spots
• flame haemorrhages

Question 21

management of R1

Answer 21

prescreen in 12 months

Question 22

R2

Answer 22

moderate non-proliferative retinopathy with four or more blot haemorrhages in one hemi-field only

Question 23

management of R2

Answer 23

prescreen in 6 months

Question 24

R3

Answer 24

severe non-proliferative diabetic retinopathy with any of the following features:

• four or five blot haemorrhages in both superior and inferior semi-fields
• venous bleeding
• IRMA

Question 25

management of R3

Answer 25

refer to ophthalmology

Question 26

R4

Answer 26

profilerative diabetic retinopathy with any of the following features:

• active new vessels
• vitreous haemorrhage

Question 27

management of R4

Answer 27

referral to ophthalmology who will treat

Question 28

macular grading

Answer 28

MI OR M2

Question 29

M1

Answer 29

any hard exudates within a radius of greater than 1 but less than 2 disc diameters of the centre of the fovea, prescreen in 6 months

Question 30

M2

Answer 30

any hard exudates or blot haemorrhages within a radius of more than one disc diameters of the centre of the moves, refer to ophthalmology

Question 31

investigations for diabetic retinopathy

Answer 31

ophthalmoscopy and optical coherence tomography

Question 32

management

Answer 32

• anti-vascular endothelial growth factor injections (anti-VEGF)
• laser therapy

Question 33

other eye pathologies in diabetics

Answer 33

cataracts, glaucoma

Question 34

cataracts

Answer 34

opacity of the crystalline lens causing a haziness/ cloudiness of vision, often the intimal presentation of cataracts is lekocoria (white pupil)

Question 35

glaucoma

Answer 35

group of eye diseases that are caused by intra-ocular hypertension which damages the optic nerve