Retinopathy - Diabetic, Hypertensive (2)

Question 1

Diabetic Retinopathy:
What occurs here?

What is it classified into?

What are the fundoscopic findings?

What are the complications?

Answer 1

➊ • Hyperglycaemia leads to damage of small retinal vessels and endothelial cells – This makes the vessels more leaky, therefore leading to blot haemorrhages and hard exudates (deposits of lipids in the retina)
• Damage to nerve fibres cause fluffy white patches to form – Cotton wool spots
• Neovascularisation – VEGF released into the retina

➋ • Non-proliferative – No neovascularisation
• Proliferative – With neovascularisation

➌ • Mild disease – Microaneurysms (Dots), Hard exudates, Blot haemorrhages
• Severe disease – Cotton wool spots, Large blot harmorrhages

➍ • Retinal detachment
• Vitreous haemorrhage
• Optic neuropathy
• Cataracts

Question 2

Hypertensive Retinopathy:
What occurs here?

Answer 2

• Damage to retinal vessels due to systemic HTN – Can be a result of chronic hypertension or can develop quickly as a result of malignant hypertension
• Silver wiring is where arteriole walls become thickened and sclerosed, causing increased reflection of the light
• AV Nipping is where arterioles compress on veins as they cross
• Damage to nerve fibres cause fluffy white patches to form – Cotton wool spots
• Damage to retinal small vessels and endothelial cells – This makes the vessels more leaky, therefore leading to blot haemorrhages and hard exudates (deposits of lipids in the retina)
• Papilloedema due to ischaemia to optic nerve, resulting in oedema