Diabetic retinopathy

Question 1

What type of diabetes is most likely to be affected.

Answer 1

T2DM

Question 2

What is pre-proliferative DR

Answer 2

Capillaries are damaged resulting in microaneurysms which appear as red dots in the retina (1st clinical sign)
Increased vascular permeability makes the capillaries ‘leaky’ proteins and lipids leak out and get trapped, appearing as yellow white flecks on the retina - ‘hard exudates’
this stage may or may not be asymptomatic, begins 20 yrs after DM diagnosed

Question 3

What is proliferative DR?

Answer 3

Usually symptomatic (blurry Vision, floaters)
Microvascular damage in preproliferative retinopathy results in ischaemia, so retina produces VGEF to compensate for ischaemia which produces new blood vessels, these BVs are abnormal and retina is usable to compensate for the ischaemia (lots of lighter squiggly vessels)
This stage can result in VH or retinal detachment

Question 4

What is the treatment of DR/

Answer 4

1. Prevention - BM control (doesn’t always work!!), yrly eye exam
2. Asymptomatic w PP - same as 1. Sx? -> anti-VGEF meds
3. PDR - laser photocoagulation, stop growth of vessels, not curative but prevents complications e.g RD, VH which can result in permanent blindness