Ophthalmology - Diabetic Retinopathy Flashcards
What is diabetic retinopathy?
Damage to the retinal blood vessels due to prolonged high blood sugar levels
What does hyperglycaemia mean in diabetic retinopathy?
Damages retinal small vessels and endothelial cells
What is the pathophysiology of diabetic retinopathy?
Hyperglycaemia damages retinal small vessels and endothelial cells
Increased vascular permeability leads to leaking blood vessels, blot haemorrhages and hard exudates
Damage to blood vessel walls leads to microaneurysms and venous beading
Damage to nerve fibres in the retina then causes fluffy white patches - cotton wool spots- to form on the retina
Intraretinal microvascular abnormalities can act a shunt between arterial and venous vessel in the retina
Leads to neovascularisation
What are hard exudates?
Yellow-white deposits of lipids and proteins in the retina
What are microaneurysms?
Small bulges in the blood vessel walls
What is venous beading?
Walls of veins that are no longer straight and parallel, resembling a string of beads
What are cotton wool spots?
Fluffy white patches on the retina caused by damage to nerve fibres
What do intraretinal microvascular abnormalities (IRMA) refer to?
Dilated and tortuous capillaries in the retina
What is neovascularisation?
Release of growth factors in the retina that stimulates new blood vessel development
What are the three grades of diabetic retinopathy?
Background
Microaneurysms
Retinal haemorrhages
Hard exudates
Cotton wool spots
Pre-proliferative
Venous beading
IMRA
Proliferative
Neovascularisation
Vitreous haemorrhage
What is diabetic maculopathy?
Exudates within the macula
Macular oedema
What is the main distinction in diabetic retinopathy grading?
Between non-proliferative (background and pre-proliferative) and proliferative diabetic retinopathy
Ket feature of proliferative diabetic retinopathy is neovascularisation
What are some complications of diabetic retinopathy?
- Vision loss
- Retinal detachment
- Vitreous haemorrhage
- Rubeosis iridis
- Optic neuropathy
- Cataracts
What is Rubeosis iridis?
New blood vessel formation in the iris
Can lead to neovascular glaucoma
What is the management for non-proliferative diabetic retinopathy?
Close monitoring and careful diabetic control
Pan-retinal photocoagulation images
