Flashcards in 6 - Opth - Retinal disease - Diabetic Retinopathy Deck (19):
commonest cause of visual impairment and blindness in who?
working age population
What happens (simply)
occlusion +/-leakage in retinal vessels
poor DM control
2 main types
proliferative and non-proliferative - maculopathy can occur with both
Non-proliferative DR - symptoms? when occurs? how classified?
-usually aSx - unless maculopathy
-after 8-10y DM
-rated as mild, moderate, severe based on ischaemia degree
NPDR - signs
haemorrhages (dots/blots - deep in retina, flames - in nerve fibre layer)
hard exudates (yellow patches - leaked lipoproteins from diseased vasculature)
cotton wool spots - retinal nerve fibre layer infarction
signs of severe NPDR - (pre-proliferative)
large number of dark haemorrhages, irreg vessel dilatation 9beading) and vneous dilatation
most progess from severe NPDR to PDR within 12 months
Proliferative DR - more common in which DM? occurs in how many DM pts? characterised by?
formation of new vessels on optic disc and retina (neovascularisation)
Signs of PDR
new vessels appear initially flat but enlarge and branch irregularly into vitreous (tuffs)
Complications of PDR
risk of vitreous haemorrhage
rubeotic glaucoma (due to new vessel growth on iris blocking drainage)
retinal fibrosis -> tractional retinal detachment
Diabetic maculopathy- what significantly threatens vision? occurs in? more common in?
may occur in both NPDR + PDR
more common in T2DM
3 types of maculopathy
focal, diffuse, ischaemic
leakage from capillaries in one part of macula -> retinal thickening and surrounding exudates (circinates)
diffuse retinal oedema from dilated capillaries - maybe ass w haemorrhages but rarely exudates
closure of foveal capillary networks -> diffuse oedema and dark haemorrhage
confirm ischaemia with fluorescein angiography
DR management - first principle
control DM and RF's
DR mgmt - laser photocoagulation for?
-PAn retinal photocoagulation in PDR
-focal/grid photocoagulation in maculopathy
What can you combine with photocoagulation in maculopathy? what if persistent vitreous haemorrhage?