Diabetic retinopathy

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For medical students

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DIABETES AND THE EYE:

DIABETES AND THE EYE

EPIDEMIOLOGY:

EPIDEMIOLOGY Commonest cause of blindness in the population of working age in developed countries Prevalence of DR of any severity in the diabetic population is 30% and prevalence of blindness due to DR is approximately 5%

PATHOGENESIS:

PATHOGENESIS

RISK FACTORS:

RISK FACTORS Duration of DM Control of DM. Will not prevent but delays Hypertension Renal Disease Pregnancy Obesity, hyperlipidaemia, smoking, anaemia

CLINICAL CLASSIFICATION OF DIABETIC RETINOPATHY:

CLINICAL CLASSIFICATION OF DIABETIC RETINOPATHY Background Pre-proliferative Proliferative End-stage diabetic eye disease

Background :

Background Blot haemorrhage Exudate Microaneurism

Diabetic maculopathy:

Diabetic maculopathy Hard exudate

Pre-proliferative:

Pre-proliferative Vascular tortuosity Haemorrhage CWS Microaneurism

Proliferative retinopathy:

Proliferative retinopathy NVD NVE Laser burn scars Pre-retinal haemorrhage

Advanced diabetic eye disease:

Advanced diabetic eye disease Preretinal fibrosis and tractional retinal detachment Rubeosis iridis

End-stage diabetic eye disease:

End-stage diabetic eye disease PHTHISIS Shrunken, soft eye with opaque vascularised cornea and no visual potential

TREATMENT:

TREATMENT LASER: Light Amplification by the Stimulated Emission of Radiation Focal Grid Panretinal photocoagulation Injections Sugery

SCREENING :

SCREENING No retinopathy or BDR with normal vision See yearly, or sooner if vision deteriorates Refer to ophthalmologist BDR with macular changes BDR with decrease in vision Pre-proliferative retinopathy Proliferative retinopathy

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