week 2 eye in systemic disease: systemic disease Flashcards
what kinds of systemic disease can cause eye disease?
CV disease
inflammatory
CTD
what CV disease can cause eye disease?
Diabetes
Hypertension
Vascular Occlusion
what inflammatory disease can cause eye disease?
Granulomatous Disease
Giant Cell Arteritis
Thyroid Eye Disease
what CTD disease can cause eye disease?
SLE
RA
marfans
pathogenesis of diabetic retinopathy
chronic hyperglycaemia→ glycosylation of protein/basement membrane→ loss of pericytes→ micro aneurysm →leakage and ischaemia
Signs of non proliferative diabetic retinopathy
microaneurysms / dot + blot haemorrhages hard exudate cotton wool patches abnormalities of venous calibre Intra-retinal microvascular abnormailities (IRMA)
are new vessels good at back of diabetic eye?
No.
try to avoid these as they easily haemorrhage leading to fibrosis and loss of function
what types of new vessels can be seen in diabetic retinopathy?
grow on disc (NVD)
grow in the periphery (NVE)
grow on iris if ischaemia is severe (blindness precedes this usually )
what is Rubeosis iridis?
neovascularisation of the iris. (late sign), grows into trabecular meshwork and stops aqueous draining out of the eye, leading to very high IOP and is painful (potentially glaucoma too)
what is usual IOP?
<21
why do diabetic patient lose vision?
- retinal oedema affecting the fovea
- vitreous haemorrhage
- scarring/ tractional retinal detachment
how is diabetic retinopathy classed?
No retinopathy
non-proliferative: =mild, moderate, severe
proliferative retinopathy
how is diabetic eye disease assessed?
retinopathy and maculopathy
how is diabetic maculopathy classed?
No maculopathy
observable maculopathy
referable maculopathy
clinically significant maculopathy
how is diabetic eye disease managed?
Optimise medical management
Laser = PRP, Macular grid
Surgery – vitrectomy
Rehabilitation (blind/partial sighted)
