DIABETES AND THE EYE. EPIDEMIOLOGY Commonest cause of blindness in the population of working age in...

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DIABETES AND THE EYE

Transcript of DIABETES AND THE EYE. EPIDEMIOLOGY Commonest cause of blindness in the population of working age in...

Page 1: DIABETES AND THE EYE. EPIDEMIOLOGY Commonest cause of blindness in the population of working age in developed countries Prevalence of DR of any severity.

DIABETES AND THE EYE

Page 2: DIABETES AND THE EYE. EPIDEMIOLOGY Commonest cause of blindness in the population of working age in developed countries Prevalence of DR of any severity.

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%

Page 3: DIABETES AND THE EYE. EPIDEMIOLOGY Commonest cause of blindness in the population of working age in developed countries Prevalence of DR of any severity.

PATHOGENESIS

Page 4: DIABETES AND THE EYE. EPIDEMIOLOGY Commonest cause of blindness in the population of working age in developed countries Prevalence of DR of any severity.

RISK FACTORS

• Duration of DM

• Control of DM. Will not prevent but delays

• Hypertension

• Renal Disease

• Pregnancy

• Obesity, hyperlipidaemia, smoking, anaemia

Page 5: DIABETES AND THE EYE. EPIDEMIOLOGY Commonest cause of blindness in the population of working age in developed countries Prevalence of DR of any severity.
Page 6: DIABETES AND THE EYE. EPIDEMIOLOGY Commonest cause of blindness in the population of working age in developed countries Prevalence of DR of any severity.

CLINICAL CLASSIFICATION OF DIABETIC RETINOPATHY

• Background

• Pre-proliferative

• Proliferative

• End-stage diabetic eye disease

Page 7: DIABETES AND THE EYE. EPIDEMIOLOGY Commonest cause of blindness in the population of working age in developed countries Prevalence of DR of any severity.

Background

Blot haemorrhageExudate

Microaneurism

Page 8: DIABETES AND THE EYE. EPIDEMIOLOGY Commonest cause of blindness in the population of working age in developed countries Prevalence of DR of any severity.

Diabetic maculopathy

Hard exudate

Page 9: DIABETES AND THE EYE. EPIDEMIOLOGY Commonest cause of blindness in the population of working age in developed countries Prevalence of DR of any severity.

Pre-proliferative

Vascular tortuosity

Haemorrhage

CWS

Microaneurism

Page 10: DIABETES AND THE EYE. EPIDEMIOLOGY Commonest cause of blindness in the population of working age in developed countries Prevalence of DR of any severity.

Proliferative retinopathy

NVD NVE

Laser burn scars

Pre-retinal haemorrhage

Page 11: DIABETES AND THE EYE. EPIDEMIOLOGY Commonest cause of blindness in the population of working age in developed countries Prevalence of DR of any severity.

Advanced diabetic eye diseasePreretinal fibrosis and tractional retinal detachment

Rubeosis iridis

Page 12: DIABETES AND THE EYE. EPIDEMIOLOGY Commonest cause of blindness in the population of working age in developed countries Prevalence of DR of any severity.

End-stage diabetic eye disease

• PHTHISIS

Shrunken, soft eye with

opaque vascularised

cornea and no visual

potential

Page 13: DIABETES AND THE EYE. EPIDEMIOLOGY Commonest cause of blindness in the population of working age in developed countries Prevalence of DR of any severity.

TREATMENT

• LASER: Light Amplification by the Stimulated Emission of Radiation– Focal

– Grid

– Panretinal photocoagulation

Page 14: DIABETES AND THE EYE. EPIDEMIOLOGY Commonest cause of blindness in the population of working age in developed countries Prevalence of DR of any severity.

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