Diabetic Retinopathy Flashcards
What is Diabetic retinopathy?
Retinal vasculopathy due to DM
Which vessels are affected in diabetic retinopathy?
Precapillary aaa, vvv + capillaries
What is the incidence of DR most related to?
Duration of DM
RF DR (8)
Duration DM*** Age Smoking Control DM (poor) HTN Hyperlipidaemia Renal impairment Pregnancy
How long after having DM does NPDR tend to occur?
> 8-10years after
Features NPDR on fundoscopy (7)
Microaneurysms Exudates Retinal haemorrhages CW spots Vascular dilatations Calibre variations Intraretinal microvascular abnormalities (IRMA)
What is a microaneurysm
Focal dilatations of retinal capillaries which leak
What is a haemorrhage
Dot (small)
Blot (large) from vv reintal caps
Flame = nn fibre layer
What is a CW spot
Greyish white, fluffy edged lesions in nn fibre layer (axoplasmic accum)
If NPDR is severe, how long will it be until it becomes PDR?
12 months
What % people with DM have PDR?
5%
Which type of diabetes is more susceptible to PDR?
T1DM
Features early PDR
Neovascularisation
Fragile –> vitreious haemorrhage
What vasculature is affected in PDR?
vv
Late changes PDR (3)
Retinal fibrosis
Traction - retinal detachment
Rubeosis iridis + neovascular glaucoma
Which type of diabetes is more likely to get diabetic maculopathy?
T1
What are the 3 types of diabetic maculopathy?
Focal
Diffuse
Ischaemic
Features focal diabetic maculopathy
Focal leaking from microaneurysms
–> focal retinal thickening + surrounding exudates
Features diffuse diabetic maculopathy
Diffuse leakage dilated capillaries
Retinal oedema, retinal haemorrhages, no exudates
Features ischaemic Diabetic maculopathy
Closure cap network
Diffuse oedema
Dark haemorrhages
How can Ischaemic diabetic maculopathy be confirmed?
Fluorescein angiography
Mx DR
Control DM/other RF
laser photocoagulation
