Vitreous & Retina

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Retinal Vascular Diseases
Nonproliferative Diabetic Retinopathy

  • Most common form of diabetic retinopathy.
  • After 20 years of the disease, almost 100% of patients with type 1 and 60% of type 2 have some degree of retinopathy.
  • Clinical features:
    • Signs:
      • Microaneurysm, intraretinal hemorrhages, cotton wool spots and hard exudates
      • Venous tortuosity or beading, capillary dropout and intraretinal microvascular abnormalities (IRMA)
      • Increasing formation of microaneurysm leads to increased vascular permeability of the retinal capillaries and result in retinal edema particularly in the macular area
  • Fluorescein angiography demonstrates:
    • Scattered hyperfluorescence dots of microaneurysms which can be associated with minimal dye leakage
    • Spots of hypofluorescense in the area of hemorrhages and exudates
    • Areas of irregular capillary pattern or capillary closure
  • Management:
    • Improve patients education and understanding about the disease process.
    • Control of blood glucose, cholesterol and blood pressure.
    • Photocoagulation in severe nonproliferative retinopathy.
    • Annual check-up 5 years after onset for patient aged less than 30 years old, and at time of diagnosis for patients aged 30 and older.
    • Frequency of scheduled check-up depends on the status of the retinopathy.

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