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Diabetic Retinopathy (Proliferative retinopathy (These factors cause new…
Diabetic Retinopathy
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Maculopathy
Above a certain rate of formation, clearance fails and macular oedema occurs
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Fluid from leaking vessels is cleared poorly in the macular area (since its anatomy differs from that of the rest of the retina)
If sustained, this distortion causes loss of central vision
Microaneurysms
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This causes reduction in junctional contact with endothelial cells leading to fluid leakage as well as micro aneurysms
These form due to metabolic consequences of poorly controlled diabetes causing intramural pericyte death and thickening of basement membrane of the small blood vessels
Haemorrhages
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The fluid is cleared into the retinal veins, leaving behind protein and lipid deposits resulting in hard exudates which are bright yellowish white in colour and are seen on fundoscopy
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Treatment
Laser therapy, it doesn't improve sight but stabilises deterioration and prevents progression, but risks include loss of night vision and the loss of peripheral vision
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Can reduce risk by keeping HbA1c below 7% since each % increase = an exponential increase in diabetic retinopathy progression
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