Diabetic Retinopathy
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Diabetic Retinopathy
- Significant cause of blindness
- Due to chronic hyperglycemia + high blood pressure
- May worsen in pregnancy when blood glucose control is impaired.
- Prevention and treatment requires control of blood glucose and pressure.
- Screen all patients with diabetes annually/pregnant patients every trimester.
Stages
Nonproliferative retinopathy
- Increased capillary permeability with hemorrhage, microaneurysyms, exudates, macular ischemia and retina thickening from leaked capillary fluid.
- This edema is a top cause of blindness due to diabetic retinopathy.
- Look for: capillary microaneurysms, hard or soft exudates, dot and blot retinal hemorrhages.
- Treat edema with antivascular endothelial growth factor drugs, focal laser, intraocular corticosteroid implants, or vitrectomy.
Proliferative retinopathy
- Neovascularization in the vitreous surface of the retina, which can lead to vitreous hemorrhage.
- Preretinal fibros tissue can develop and lead to retinal detachment.
- Neovascularization in the anterior segments of the eye can lead to glaucoma.
- Look for: blurred vision/floaters/flashing lights with sudden vision loss.
- Treat with antivascular endothelial growth factor drugs, panretinal laser photocoagulation, vitrectomy.