Overview
What is the general impact of diabetes mellitus (DM)?
What are the ophthalmic complications of diabetes mellitus (DM)?
What is the early presentation of diabetic retinopathy?
Which lab studies are indicated in the workup of diabetic retinopathy?
How can the progression of diabetic retinopathy be reduced?
What are the signs and symptoms of diabetic retinopathy?
How is nonproliferative diabetic retinopathy characterized?
How is proliferative diabetic retinopathy characterized?
Which lab and imaging studies are indicated in the workup of diabetic retinopathy?
Which medications are used in the management of diabetic retinopathy?
What is the role of glucose control in the management of diabetic retinopathy?
When is laser photocoagulation indicated in the management of diabetic retinopathy?
What is the role of vitrectomy in the management of diabetic retinopathy?
What is the role of cryotherapy in the management of diabetic retinopathy?
What is the pathogenesis of diabetic retinopathy?
How are capillary changes characterized in diabetic retinopathy?
What is the role of macular edema in the pathophysiology of diabetic retinopathy?
What is the role of hypoxia in the pathophysiology of diabetic retinopathy?
How common is diabetic retinopathy in patients with type 1 or type 2 diabetes?
What is the role of hypertension and hyperlipidemia in the etiology of diabetic retinopathy?
How is diabetic retinopathy characterized in pregnant women with diabetes?
What is the epidemiology of diabetic retinopathy?
What are the prognostic factors for visual loss in diabetic retinopathy?
What is the prognosis of diabetic retinopathy?
What is the importance of patient education in the management of diabetic retinopathy?
Which health concerns should be addressed in the patient education on diabetic retinopathy?
Presentation
What is the initial presentation of diabetic retinopathy?
How is diabetic retinopathy diagnosed?
What are the early signs of diabetic retinopathy?
What are dot and blot hemorrhages in diabetic retinopathy?
What are flame-shaped hemorrhages in diabetic retinopathy?
What causes retinal edema and hard exudates in diabetic retinopathy?
What are cotton-wool spots in diabetic retinopathy?
What are venous loops and venous beading in diabetic retinopathy?
What are intraretinal microvascular abnormalities in diabetic retinopathy?
What is the significance of macular edema in diabetic retinopathy?
What are the characteristics of nonproliferative diabetic retinopathy?
What are the characteristics of proliferative diabetic retinopathy?
DDX
What are diagnostic considerations in diabetic retinopathy?
What are the differential diagnoses for Diabetic Retinopathy?
Workup
What are approach considerations in the workup of patients with diabetic retinopathy?
What is the importance of fasting glucose and HbA1c in the workup of diabetic retinopathy?
What is the role of fluorescein angiography in the workup of diabetic retinopathy?
What is the role of optical coherence tomography (OCT) in the workup of diabetic retinopathy?
What is the role of B-scan ultrasonography in the workup of diabetic retinopathy?
Treatment
What are the approach considerations in the treatment of diabetic retinopathy?
What is the importance of glucose control in the management of diabetic retinopathy?
Is aspirin therapy indicated in the management of diabetic retinopathy?
What is the role of ovine hyaluronidase therapy in the management of diabetic retinopathy?
What is the role of VEGF inhibitors in the management of diabetic retinopathy?
How effective are VEGF inhibitors in the management of diabetic retinopathy?
What is the role of laser photocoagulation in the management of diabetic retinopathy?
What are the indications for vitrectomy in the treatment of proliferative diabetic retinopathy?
When is cryotherapy indicated in the treatment of proliferative diabetic retinopathy?
How can diabetic retinopathy be prevented?
Which specialist consultations are indicated in the treatment of diabetic retinopathy?
What is the follow-up care in the treatment of diabetic retinopathy?
What is the role of exercise in the management of diabetic retinopathy?
Guidelines
What are the guidelines for the treatment and surveillance of diabetic retinopathy?
Medications
Which medications are indicated for treatment of diabetic retinopathy?
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Fundus photograph of early background diabetic retinopathy showing multiple microaneurysms.
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Retinal findings in background diabetic retinopathy, including blot hemorrhages (long arrow), microaneurysms (short arrow), and hard exudates (arrowhead).
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Fluorescein angiogram demonstrating an area of capillary nonperfusion (arrow).
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Fluorescein angiogram demonstrating foveal dye leakage caused by macular edema.
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Fundus photograph of clinically significant macular edema demonstrating retinal exudates within the fovea.
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New vessel formation on the surface of the retina (neovascularization elsewhere)
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An area of neovascularization that leaks fluorescein on angiography.
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Boat-shaped preretinal hemorrhage associated with neovascularization elsewhere.
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Fibrovascular proliferations within the vitreous cavity
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Extensive fibrovascular proliferations within and around the optic disc