Diabetic Retinopathy

FACTS
Diabetic retinopathy (DR) is the major cause of new blindness among adults aged 2074 years. Approximately 700,000 persons in the United States have proliferative diabetic retinopathy.

FACTS
Incidence 65,000 persons per year. In the United States there exists a high prevalence of Diabetic retinopathy 28.5% among those with diabetes and aged 40 years or older.

Stages of Diabetic Retinopathy

Mild NPDR is characterized by microaneurysms and dot/blot hemorrhages . Microaneurysms appear as bright red spots, are often the first sign of retinopathy.

Moderate NPDR is characterized by marked hemorrhages or microaneurysms, cotton wool spots (CWS) venous beading (VB), and intraretinal micro vascular abnormalities.

Severe NPDR is characterized by the 4-2-1 rule. 1. Marked hemorrhages in all 4 quadrants 2. Venous beading in 2 quadrants 3. Moderately severe intra retinal microaneurysms (IRMAs) in one quadrant. Very severe NPDR occurs when 2 of the 3 criteria above occurs.

The hallmark of PDR is neovascularization neovascularization of the disk, is new vessels growth on or within 1 disc diameter of the optic disc. (NVD) All other is termed neovascularization elsewhere (NVE).

Clinically Significant Macular oedema (CSMO)

scaffold of fibrous tissue progressive proliferative phase