Diabetic retinopathy Flashcards
How many times more likely are diabetic patients to go blind?
25
What would you find in pre-proliferative retinopathy?
flame, dot and blot haemorrhages venous beading venous looping intra-retinal microvascular abnormalities cotton wool spots
Background retinopathy?
microaneursyms and intra-retinal haemorrhages
What are exudates?
leakage of lipoproteins from retinal vasculature
What are cotton wool spots?
microinfarts of retinal nerve fibres: exposed axons extrude their axoplasm into the retina
What would severe NPDR show? How soon will it progress to PDR?
dark haemorrhages, dilation of retinal veins, beading and IRMA
12 months
True or false: proliferative disease is more common in Type 1 than 2 DM
True. 5% of diabetics in general
Describe neovascuarisation in PDR
Formation of new blood vessels in response to hypoxia, arising from veins, initially flat but enlarge and move towards the vitrous. The problem is that they are quite weak and prone to bleeding. Thus they can easily cause pre-retinal haemorrhage or vitrous haemorrhage. Subsequently there might be retinal fibrosis and traction retinal detachment
Why is anti-VEGF useful in preventing rubeosis iridis and neovacular glaucoma?
As well as reducing neovascularisation
Following retinal fibrosis and traction retinal detachement, VEGF can enter the anterior segment of the eye to cause these symptoms!
Key differences between hypertensive retinopathy and DR
DR is ‘‘wetter’’
less cotton wool, more haemorrhages, oedema and exudate
Why is anti-VEGF useful in preventing rubeosis iridis and neovascular glaucoma?
As well as reducing neo-vascularisation
Following retinal fibrosis and traction retinal detachment, VEGF can enter the anterior segment of the eye to cause these symptoms!
what is the most common cause of vision loss in diabetics?
While the effects of neovascularization in PDR can be devastating, the most common cause of vision loss in diabetics is macular edema. Macular edema can occur in NPDR, but it is more common in more severe cases of DR due to the leakiness of the new blood vessels
What is diabetic maculopathy?
Diabetic maculopathy is a specific type of DR and affects the macula
it can occur in proliferative or non- proliferative DR
• It is more common in type 2 DM, but can occur in either it leads to visual loss if untreated
What other ways can diabetes cause problems in the eye/with the eye?
Increased incidence of eyelid infections and cataracts
o Cranialnervepalsies of 3,4 and 6
o Delayed healing of corneal abrasions and corneal ulcers o More severe post-operative intraocular inflammation
o Abnormalwoundhealing
