Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

m4 EYE > Ocular manifestations of systemic disease: DM > Flashcards

Ocular manifestations of systemic disease: DM Flashcards

1
Q

Ocular manifestations of diabetes

A
  1. Refractive Changes
    - Fluctuation in blood sugar
    - Stabilizing of blood sugar will help stop refractive changes
  2. Extraocular muscles
    - DM affects 3rd/6th
  3. Pupil and iris abnormality
    - Respond sluggishly to light or fail to dilate with mydriatic eyedrops
    - Rubeosis Iridis (neovascularization)
  4. Cataract
  5. Ischemic optic neuropathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Risk factors of diabetic retinopathy

A

Duration of DM
Level of glycemic control
HTN/ HLD/ Obesity
Renal Disease/ Anemia
Pregnancy
Smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Classifications of DM retinopathy

A
  1. Non-proliferative DM retinopathy
  2. Proliferative DM retinopathy
  3. Maculopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Non-proliferative DM retinopathy

A

Absence of abnormal blood vessels
- Mild
- Moderate
- Severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What can be observed in mild non-proliferative DM retinopathy?

A

Microaneurysms: Weakened arterioles/capillaries earliest sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What can be observed in moderate non-proliferative DM retinopathy?

A
  • Dot and blot hemorrhages
  • Flame-shaped hemorrhages
  • Cotton wool spots (Damage to nerve fibres)
  • Hard Exudates (Sharply defined, bright yellow) 2° to leakage of lipids and proteins from microaneurysm
  • Retinal Edema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When should microaneurysm be treated?

A

Microaneurysm near macular require treatment; but exudation with edema away from macular do not need to be treated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What can be observed in severe non-proliferative DM retinopathy?

A

4 or 2 or 1 rule
- Dark blot hemorrhages in 4 quadrants
- Venous beading/looping/segmentation in ≥2 quadrants
- Intra-retinal microvascular abnormalities (IRMA) in ≥1 quadrant

Cotton wool spots
Anyone with severe NPDR requires treatment

*Cotton wool spots and venous beading are signs of ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Proliferative DM retinopathy

A

Neovascularization (New vessel formation) occurs as a response to retinal ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Location of new vessels in proliferative DM retinopathy

A

New vessel disc
New vessel elsewhere

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Visual loss in proliferative DM retinopathy can be due to

A

Vitreous haemorrhage
Tractional retina detachment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Maculopathy in DM retinopathy

A

Hard exudates and edema in macular and retina thickening
- can lead to visual loss
- diagnosed by Optical Coherence Tomography (OCT) (presence of edema)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is macular edema?

A
  • Abnormal leakage and accumulation of fluid in the macular from damaged blood vessels
  • Swelling and subsequently thickening of the macular can cause vision to distort
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Causes of macular edema

A
  1. Diabetic Macular Edema
    - Microaneurysm causing leakage of lipids
    - Can lead to loss of vision
  2. Post eye surgery
  3. Age related macular degeneration
    - Deterioration and breakdown of macula
    - Neovascular AMD or “wet” AMD allows for blood vessel which can grow in the choroid which can leak
  4. Inflammatory disease affecting the eye
    - Uveitis
  5. Blockage of retinal blood vessels
    - E.g. Retinal vein occlusion 2’ atherosclerosis
    - Leakage into retina, regulating in macular edema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Symptoms of macular edema

A

Asymptomatic
Blurry/ wavy vision near or in centre of vision field
Colour desaturation
Can lead to vision loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Investigations for macular edema

A
  • VA
  • Optical Coherence Tomography
  • Fluorescein angiogram (Inject dye into blood vessels of retina to look for any damage)
  • Amsler Grid: Metamorphopsia
17
Q

Management for macular edema

A
  • Focal: Macular Focal Laser Photocoagulation
  • Diffused: Anti-VEGF Injection/Intra-vitreal injections of corticosteroids
  • Corticosteroid/NSAIDs (Reduces inflammation)
  • Vitrectomy removes vitreous gel to reduce pulling on the macula
18
Q

Complications of diabetic retinopathy

A

Neovascular glaucoma
Vitreous haemorrhage
Tractional retinal detachment
DM macular edema
-> leads to blindness

19
Q

Management of DM retinopathy

A
  • Screening: Regular DM retinal photography
  • Tight glycemic control (HbA1c ≤ 7%,)
  • Control comorbidities/cardiovascular risk factors (HTN, HLD, renal disease)
  • Pan-retinal photocoagulation (PRP) for PDR/ Severe NPDR
  • Focal: Macular Focal Laser Photocoagulation
  • Diffused: Anti-VEGF Injection/Intra-vitreal injections of corticosteroids
  • Vitrectomy
20
Q

When stating diagnosis for DRP there are 2 parts of reporting the diagnosis

A
  1. state presence/absence of diabetic macular disease
  2. degree + type of diabetic retinopathy
21
Q

Complications of Intra-vitreal injections of corticosteroids

A
  • Transient increase in IOP
    -Injection related infectious endophthalmitis
  • Sterile intraocular inflammation (SII)
  • Brolucizumab-associated retinal vasculitis (BARV)
22
Q

Classifications of maculopathy

A

Centre-involving (CSME) vs Non centre-involving

23
Q

Criteria of clinically significant macular edema

A
  1. Retinal thickening within 500 microns of macular centre
  2. Hard exudates within 500 microns of macular centre with adjacent retinal thickening
  3. ≥1 disc diameters of retinal thickening, part of which is within 1 disc diameter of macular centre

Any 1 of the above present = CSME

m4 EYE (28 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions