[Ophth] Diabetic Retinopathy Flashcards

1
Q

what are the consequences of poorly managed diabetes?

A
  • diabetic retinopathy
  • nephropathy
  • neuropathy
  • peripheral vascular disease
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2
Q

what will diabetic retinopathy eventually progress into?

A

maculopathy

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3
Q

what are the sx of diabetic retinopathy?

A

asx until advanced

then blurred vision, reduced acuity and ‘floaters’

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4
Q

what is the mx for diabetic retinopathy?

A
  1. improve diabetic control, BP and lipid levels
    - lifestyle and diet advice
    - pharmacological therapies
    - stop smoking
  2. prescription glasses/lenses
  3. laser photocoagulation when advanced
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5
Q

what are the classes of diabetic retinopathy?

A
  • pre-proliferative (mild)
  • pre-proliferative (moderate)
  • pre-proliferative (severe)
  • proliferative
  • diabetic maculopathy
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6
Q

what are the sx for pre-proliferative diabetic retinopathy?

A

none

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7
Q

what are the features seen on fundoscopy for pre-proliferative (mild) diabetic retinopathy?

A

microaneurysms

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8
Q

what are the features seen on fundoscopy for pre-proliferative (moderate) diabetic retinopathy?

A
  • dot and blot haemorrhages

- hard exudates

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9
Q

what are the features seen on fundoscopy for pre-proliferative (severe) diabetic retinopathy?

A
  • large dot and blot haemorrhages
  • cotton wool spots
  • venous beading
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10
Q

what are the sx of proliferative diabetic retinopathy?

A
  • floaters

- reduced acuity

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11
Q

what are the features seen on fundoscopy for proliferative diabetic retinopathy?

A

as in pre-proliferative + new vessel formation

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12
Q

what are the sx of diabetic maculopathy?

A
  • blurred vision

- reduced acuity

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13
Q

what are the features seen on fundoscopy for diabetic maculopathy?

A

as in proliferative + retinal thickening and macular leaking

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14
Q

what would you do if you saw a pt with proliferative diabetic retinopathy / diabetic maculopathy?

A

urgent ophthalmology review: ideally same day

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15
Q

what is macular degeneration (MD)?

A

progressive damage to the macula of the retina, related to age

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16
Q

what are the key features of MD?

A
  • visual loss

- fatty Drusen deposits on retina

17
Q

what is MD classified into?

A
  • ‘dry’ (90%)

- ‘wet’ (rapidly progressive)

18
Q

what is the mx for MD?

A

supportive and conservative

19
Q

what can be offered for late stage wet MD?

A

intravitreal injection of anti-VEGF to slow down progression

20
Q

what are the risk factors for MD?

A
  • smoking
  • HTN
  • older age
  • BMI >30
  • high fat diet
  • lack of exercise
  • FHx
21
Q

what are the classifications of MD?

A
  1. early MD
  2. intermediate MD
  3. late dry
  4. late wet
22
Q

what is early MD?

A

small or medium sized drusen

23
Q

what is intermediate MD?

A
  • large drusen

- retinal pigment abnormalities on retina (e.g. black spots of hypertrophy)

24
Q

what is late dry MD?

A
  • dense or confluent drusen with advanced pigmentary changes

- central visual loss

25
what is late wet MD?
- choroidal neovascularisation - retinal proliferation - bleeding and leaking on the retina - central visual loss - rapidly progressive
26
dendritic pattern on fluorescin stained cornea. dx?
herpes simplex ulcer
27
young female, BMI ++, on the OCP with headaches. dx?
idiopathic intracranial HTN → check for papilloedema
28
white fluid level visible in the anterior chamber. dx?
hypopyon
29
what is the 1st line ix for DR?
fundoscopy
30
DR and MD are...?
progressive, irreversible processes