Diabetic retinopathy Flashcards
What is diabetic retinopathy?
Damage to the retina microvascular due to chronically high glucose levels - vessels weaken and rupture, vessel walls dilate forming aneurysms, new vessels grow in late stages
What are the risk factors for diabetic retinopathy
Lengthy exposure to hyperglycaemia Duration of diabetes HTN Ethnicity - ethnic minority groups Renal disease and peripheral neuropathy - other microvascular complications Pregnancy Rapid improvement of blood sugar levels Hyperlipidaemia
What are some symptoms of diabetic retinopathy?
Floaters Blurred vision and distortion Decreased visual acuity Painless loss of vision - vitreous haemorrhage Blindness
Describe the clinical examination findings of diabetic retinopathy
Visual acuity with baily lovie chart (LogMAR chart)
Fundoscopy - gold standard is with slit lamp or fundus photography
List the three classes of diabetic retinopathy
Non proliferative
Proliferative
Diabetic macular oedema
What can non-proliferative retinopathy be further subdivided into
Background
Preproliferative
What is background retinopathy?
Presence of 1 microaneurysm
What is pre-proliferative retinopathy?
Presence of multiple microaneurysms with or without haemorrhages and hard exudates
Evidence of retinal ischaemia - venous beading, arteriolar narrowing and silver wiring
Describe proliferative retinopathy
New vessels on the disc and/or new vessels elsewhere
Can also present as retinal detachment, preretinal fibrosis and neovascular glaucoma
Describe diabetic macular oedema
Oedematous changes in or around the macula
What is a symptom of diabetic macular oedema
Blurring of central vision when reading
What are some investigations useful in diabetic retinopathy
HbA1C
OCT
FA
Describe the management of diabetic retinopathy
Glycaemic control BP control Smoking cessation and exercise Photocoagulation Intravitreal anti-VEGF Vitrectomy
What are some complications of diabetic retinopathy?
Neovascular glaucoma
