Retinopathy

Question 1

what eye pathologies are common in people with diabetes?

Answer 1

diabetic retinopathy
diabetic macular oedema
cataract (clouding of the lens)
glaucoma (increase in fluid pressure in the eye resulting in optic nerve damage - twice as common in people with diabetes)
acute hyperglycaemia (can cause reversible visual blurring)

Question 2

what are the different stages of retinopathy?

Answer 2

mild non-proliferative (background)
moderate non-proliferative
severe non-proliferative
proliferative

Question 3

how is retinopathy graded?

Answer 3

R0-R4 gets progressively worse

Question 4

how is maculopathy graded?

Answer 4

M1 and M2 (graded separately to retinopathy)

also gets progressively worse

Question 5

what are haemorrhages?

Answer 5

dot/blot/frame on fundoscopy

Question 6

what does a cotton wool spots mean?

Answer 6

ischaemic areas

Question 7

what does a hard exudate suggest?

Answer 7

lipid breakdown product

Question 8

IRMA (intra-retinal microvascular abnormalities)

Answer 8

abnormalities of blood vessels, precursor to neovascularisation (but blood vessels are patent i.e. not leaking)

Question 9

how is retinopathy managed?

Answer 9

optical coherence tomography (OCT) - used for imaging - diabetic macular oedema

• laser - pan retinal photocoagulation
• vitrectomy
• can use intravitreal anti-VEGF e.g. ranibizumab (injection) for diabetic macular oedema

Question 10

how do you screen for retinopathy?

Answer 10

annual screening for all (inc. low risk)diabetes patients, individuals needing referred to eye clinic are identified

Question 11

what are 3 bad thing diabetes are one of the leading causes for?

Answer 11

blindness
dialysis
amputation