Ophthalmology Flashcards
What is the most common cause of blindness in adults aged 35-65 years-old?
Diabetic retinopathy
This condition is prevalent among adults in this age range.
What causes increased retinal blood flow and abnormal metabolism in the retinal vessel walls in diabetic retinopathy?
Hyperglycaemia
This condition leads to damage to endothelial cells and pericytes.
What is the consequence of endothelial dysfunction in diabetic retinopathy?
Increased vascular permeability
This causes characteristic exudates seen on fundoscopy.
What predisposes to the formation of microaneurysms in diabetic retinopathy?
Pericyte dysfunction
This is a critical factor in the disease’s progression.
What is neovascularization in diabetic retinopathy thought to be caused by?
Production of growth factors in response to retinal ischaemia
This is a key feature in the progression of the disease.
What are the three classifications of diabetic retinopathy?
Non-proliferative diabetic retinopathy (NPDR), proliferative retinopathy (PDR), maculopathy
These classifications help in understanding the severity and management of the condition.
What characterizes mild non-proliferative diabetic retinopathy (NPDR)?
1 or more microaneurysm
This is the least severe form of NPDR.
What are the features of moderate non-proliferative diabetic retinopathy (NPDR)?
Microaneurysms, blot haemorrhages, hard exudates, cotton wool spots, venous beading/looping, IRMA
These features indicate a progression in severity.
What defines severe non-proliferative diabetic retinopathy (NPDR)?
Blot haemorrhages and microaneurysms in 4 quadrants, venous beading in at least 2 quadrants, IRMA in at least 1 quadrant
This is a critical stage requiring close monitoring.
What is a key feature of proliferative diabetic retinopathy (PDR)?
Retinal neovascularisation
This may lead to vitreous haemorrhage and is more common in Type I DM.
What are the key features of maculopathy?
Location-based severity, hard exudates, changes on macula, check visual acuity
This condition can be serious regardless of severity.
What should be optimized in all patients with diabetic retinopathy?
Glycaemic control, blood pressure, and hyperlipidemia
These are crucial for managing the condition.
What is the management for maculopathy if there is a change in visual acuity?
Intravitreal vascular endothelial growth factor (VEGF) inhibitors
This treatment is essential to preserve vision.
What is the management approach for severe/very severe non-proliferative retinopathy?
Consider panretinal laser photocoagulation
This is a critical intervention to prevent progression.
What is the primary treatment for proliferative retinopathy?
Panretinal laser photocoagulation
This treatment is aimed at reducing complications.
What percentage of patients develop a noticeable reduction in their visual fields after treatment for proliferative retinopathy?
Around 50%
This is due to scarring of peripheral retinal tissue.
What other complications can arise from treatment of proliferative retinopathy?
Decrease in night vision, generalised decrease in visual acuity, macular oedema
These complications can significantly affect quality of life.
What examples of intravitreal VEGF inhibitors are mentioned?
Ranibizumab
This is often used in combination with other treatments.
What is indicated if there is severe or vitreous haemorrhage in proliferative retinopathy?
Vitreoretinal surgery
This is a last-resort option for serious cases.
