Diabetic Retinopathy

Question 1

What are the 4 stages of diabetic retinopathy?

Answer 1

Background
Pre-proliferative
Proliferative
Maculopathy

Question 2

Pre-proliferative and proliferative can look reasonably similar on fundoscopy. How do they differ?

Answer 2

Both have WIDESPREAD + SEVERE

• haemorrhages
• exudates
• cotton wool spots

Proliferative
- neovascularisation (presence of new vessels)

(background retinopathy has haemorrhages + microaneurysms + exudates but less excessive)

Question 3

At what stage will the patient begin to complain of differences to vision?

How will they complain of changes?

Answer 3

Proliferative and maculopathy

Proliferative

• floaters (due to vitreous haemorrhage)
• blurred vision

Maculopathy

• blurred vision
• darkened/distorted images

Question 4

What type of diabetic is more likely to get proliferative diabetic retinopathy?

Answer 4

T1DM

Question 5

What lifestyle advice should be given to a patient? (2)

Answer 5

• Stop smoking

- Better glycaemic control

Question 6

Patients get annual eye screening as a diabetic at what retinopathy stage would they change from annual to every 4-6months?

Answer 6

Pre-proliferative

Question 7

What is kind of haemorrhage occurs deeper in the retina: flame or dot + blot?

Answer 7

Dot and blot

- more worrying

Question 8

Proliferative and maculopathy can be managed with intra-vitreal injections of 2 substances. What are these?

Answer 8

Anti-VEGF

Steroids

Question 9

What is the name for the therapy in which the retina is lasered? (has that really distinct dotting on fundoscopy?

At what stage is this treatment recommended?

Answer 9

Pan-retinal photocoagulation

Proliferative

Question 10

Diabetic retinopathy is the most common cause of blindness in the UK. T/F?

Answer 10

T