diabetic retinopathy

Question 1

what changes will you see in the retina with diabetic retinopathy?

Answer 1

cotton wool spots- caused by damage to fibres in the retina

microaneurysms- caused by damage to blood vessel walls by hyperglycaemia

hard exudates

blot haemorrhages

neovascularisation

Question 2

what are the different types of diabetic retinopathy?

Answer 2

1. non proliferative
2. proliferative
3. diabetic maculopathy

Question 3

what are the characteristics of the different severities of non proliferative diabetic retinopathy?

Answer 3

Mild: microaneurysms

Moderate: microaneurysms, blot haemorhages, hard exudates, cotton wool spots and venous beading

Severe: blot haemorrhages plus microaneurysms in 4 quadrants, venous beating in 2 quadrates, intraretinal microvascular abnormality (IMRA) in any quadrant

Question 4

what are features of proliferative diabetic retinopathy?

Answer 4

Neovascularisation

Vitreous haemorrhage

Question 5

what are features of diabetic maculopathy?

Answer 5

Macular oedema

Ischaemic maculopathy

Question 6

what are the complications of diabetic retinopathy?

Answer 6

Retinal detachment

Vitreous haemorrhage (bleeding in to the vitreous humour)

Rebeosis iridis (new blood vessel formation in the iris)

Optic neuropathy- catch all term for damage to the optic nerve

Cataracts

Question 7

what are the different management options for diabetic retinopathy?

Answer 7

Laser photocoagulation
Anti-VEGF medications such as ranibizumab and bevacizumab
Vitreoretinal surgery (keyhole surgery on the eye) may be required in severe disease