Diabetic Retinopathy (Eyes Complications)

• By Tri Nguyen
• Posted in Diabetes, Video
• On March 3, 2017
• No Comments.

1.Minimal-mild NPDR³

The prevalence of diabetes is on an increase with 280 new cases every day¹. It is estimated that up to half a million Australians are unaware that they have diabetes. This poses a high risk for diabetic retinopathy (D.R). DR is essentially leakages that occurs in the retinal blood vessels due to increased blood sugar level. It is presented in forms of microaneurysms, haemorrhages, hard exudates (fat deposits), cotton wool spots , intraretinal microvascular abnormalities, venous beading and new secondary blood vessels depending on severity.² The eye examination for DR involves a pupil dilating agent to assess the retina for patients who are diabetics or show signs of DR.

Clinically, the grading of DR severity is based on the Early Treatment Diabetic Retinopathy Study. It is an international grading scale that classifies DR into the following categories: None, Minimal Non proliferative diabetic retinopathy (NPDR), Mild NPDR, Moderate NPDR, Severe NPDR, proliferative diabetic retinopathy (PDR), High-Risk PDR.²

2.Severe NPDR⁴

When microaneurysms and retinal haemorrhages occur on the retina it is classed as minimal to mild NPDR. The recommended management is annual ocular assessment.

Moderate to severe NPDR will present with hard exudates, cotton wool spots, beading of the retinal blood vessels and servere haemorrhages. This has a high propensity to lead to proliferative DR within 12 months. Therefore regular reviews every 4-6 months is recommended and often co-managed with an ophthalmologist.

Proliferative DR has a high risk vision loss due to the presence of extensive signs seen in NPDR but in addition to formation of secondary blood vessels (black and white arrows in picture 3) or neovascularisation. These blood vessels can develop on the optic nerve head and/or on the retina. They are extremely weak and often haemorrhages forming scar tissues. Secondary blood vessels can also form on the iris which causes glaucoma by increasing the eye pressure. PDR is therefore best managed by ophthalmologists as a myriad of treatments are necessary to avoid total blindness.

3.Proliferative DR³

In summary, lost of sight due to diabetic retinopathy can be preventable with the co-management with health professionals such as a diabetic educator, general practitioner, optometrist, endocrinologist, and ophthalmologist. However the prognosis is dependent on regular monitoring of blood glucose level. Therefore it is imperative to have strict control of the diabetes once detected as losing one’s sight can have an adverse affect on quality of life.

Reference

1. https://www.diabetesaustralia.com.au/diabetes-in-australia
2. https://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/di15.pdf
3. http://diabetesmanager.pbworks.com/w/page/17680181/Diabetic%20Retinopathy#NonproliferativeDiabeticRetinopathyNPDR
4. http://www.pattyvisioncenters.com/index.php/eye_atlas/condition/severe_non_proliferative_diabetic_retinopathy

• About
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Tri Nguyen

Optometrist at Specsavers Optometrists, Tweed City S/C

Tri Nguyen graduated from Queensland University of Technology in 2004 with a Bachelor of Applied Science (Optometry). After working in Tweed Heads South and then relocating to Toowoomba for 1.5years, he undertook a Graduate Certificate of Ocular Therapeutics. He is now currently back in Tweed Heads South at Specsavers as a partner in the business. He has an interest in ocular diseases and mentoring final year optometry students.

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• Diabetic Retinopathy (Eyes Complications) - 3rd Mar, 2017