Optic disc melanocytoma
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This document presents a case study of a 18-year-old male patient diagnosed with optic disc melanocytoma in his right eye. The patient reported blurry vision and seeing a black spot in his right eye for 7 days. Examination revealed a pigmented, dark elevated lesion over the optic disc in the right eye. Investigations including color fundus photography, OCT angiogram, and B-scan confirmed the diagnosis of optic disc melanocytoma with macular edema. The patient was treated with oral steroids and proton pump inhibitors. Follow up imaging after 1 month of treatment showed resolution of the macular edema and improvement in vision. Optic disc melanocytoma is a rare, benign pigmented tumor that can cause visual
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Clinical presentation
A 40-year-old male presented with a 4-month history of painless protrusion of the left eye associated with decreasing vision. Examination found unilateral, axial proptosis of the left eye measuring 25mm. Imaging and lab tests were performed to rule out other causes. The patient underwent an excisional biopsy via orbitotomy, which was sent for histopathology.
Diabetic retinopathy
Diabetic retinopathy is a complication of diabetes that affects the blood vessels in the retina. It has four stages from mild nonproliferative retinopathy to proliferative retinopathy. Symptoms include blurred vision and gradual vision loss. Tight control of blood sugar, blood pressure, and cholesterol is important for prevention, as is not smoking and regular eye exams by an eye doctor skilled in treating diabetic retinopathy. Exams should be yearly or every 2-3 years depending on risk level.
RE Anterior uveitis case presentation
A 22-year-old male presented with complaints of pain, redness, watering and diminishing vision in his right eye for 4 days. On examination, his right eye showed signs of acute non-granulomatous anterior uveitis including swollen lids, circumciliary congestion, fine keratic precipitates, a constricted pupil with posterior synechiae, aqueous flare and cells. Blood tests and further ocular exams were recommended to confirm the diagnosis and rule out other potential causes. The treatment plan included dark glasses, warm compresses, atropine drops to break synechiae and prevent new ones from forming, and a tapering dose of prednisolone acetate drops for anti-
clinical case presentation on anterior uveitis
This clinical case presentation summarizes a 38-year-old male gardener who presented with right eye pain and redness for 5 days. On examination, his right eye showed circumcorneal congestion, grade +4 cells and grade +3 flare in the anterior chamber with posterior synechiae and miosis. He was diagnosed with acute anterior uveitis based on the unilateral eye symptoms and anterior chamber inflammation seen on examination. He was prescribed cycloplegic, antibiotic, and steroid eye drops as well as oral steroids to treat the condition.
Diabetic eye disease
Over 112,000 people in Indiana have diabetic retinopathy, which is around 20% of diabetics in the state. About 60% of diabetics receive an annual eye exam, but each year between 12,000 to 24,000 new cases of blindness occur from diabetic retinopathy. Diabetic retinopathy is caused by changes in the blood vessels in the eye and can be detected and treated through annual dilated eye exams and procedures like laser surgery. Maintaining good control of blood sugar and receiving regular eye exams can help reduce the risk of vision loss from diabetic eye disease.
Diabetic Retinopathy
1. Diabetic retinopathy is a microvascular complication of diabetes that affects the small blood vessels in the retina and is a leading cause of blindness.
2. Early changes include loss of retinal pericytes, thickening of capillary basement membranes, and formation of microaneurysms. Later stages involve proliferative retinopathy and macular edema.
3. Risk factors include duration of diabetes, poor blood glucose control, hypertension, and nephropathy. Tight control of blood glucose and blood pressure can help reduce the risk and progression of diabetic retinopathy.
Dr screening training for nurses 3 b-diabetic retinopathy
Diabetic retinopathy is a complication of diabetes that affects the retina. It begins as non-proliferative retinopathy and can progress to proliferative retinopathy, causing new blood vessels to form that can bleed. Macular edema is swelling of the macula and a leading cause of vision loss. Screening is important as early treatment with laser therapy can prevent vision loss. Intensive control of blood sugar, blood pressure, and lipids can reduce the risk and progression of retinopathy.
Diabetic retinopathy (opthalmology)
Diabetic retinopathy is a complication of diabetes mellitus where changes occur in the retina. It is a leading cause of vision loss among working age adults in Malaysia. The risk of retinopathy rises with longer duration of diabetes and poor blood glucose control. Annual eye screening is recommended to detect early signs and plan treatment. Laser photocoagulation is commonly used to treat early stages while vitrectomy may be used for advanced proliferative cases with vitreous hemorrhage. Anti-VEGF drugs combined with laser can also treat diabetic macular edema.
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Clinical presentation
A 40-year-old male presented with a 4-month history of painless protrusion of the left eye associated with decreasing vision. Examination found unilateral, axial proptosis of the left eye measuring 25mm. Imaging and lab tests were performed to rule out other causes. The patient underwent an excisional biopsy via orbitotomy, which was sent for histopathology.
Diabetic retinopathy
Diabetic retinopathy is a complication of diabetes that affects the blood vessels in the retina. It has four stages from mild nonproliferative retinopathy to proliferative retinopathy. Symptoms include blurred vision and gradual vision loss. Tight control of blood sugar, blood pressure, and cholesterol is important for prevention, as is not smoking and regular eye exams by an eye doctor skilled in treating diabetic retinopathy. Exams should be yearly or every 2-3 years depending on risk level.
RE Anterior uveitis case presentation
A 22-year-old male presented with complaints of pain, redness, watering and diminishing vision in his right eye for 4 days. On examination, his right eye showed signs of acute non-granulomatous anterior uveitis including swollen lids, circumciliary congestion, fine keratic precipitates, a constricted pupil with posterior synechiae, aqueous flare and cells. Blood tests and further ocular exams were recommended to confirm the diagnosis and rule out other potential causes. The treatment plan included dark glasses, warm compresses, atropine drops to break synechiae and prevent new ones from forming, and a tapering dose of prednisolone acetate drops for anti-
clinical case presentation on anterior uveitis
This clinical case presentation summarizes a 38-year-old male gardener who presented with right eye pain and redness for 5 days. On examination, his right eye showed circumcorneal congestion, grade +4 cells and grade +3 flare in the anterior chamber with posterior synechiae and miosis. He was diagnosed with acute anterior uveitis based on the unilateral eye symptoms and anterior chamber inflammation seen on examination. He was prescribed cycloplegic, antibiotic, and steroid eye drops as well as oral steroids to treat the condition.
Diabetic eye disease
Over 112,000 people in Indiana have diabetic retinopathy, which is around 20% of diabetics in the state. About 60% of diabetics receive an annual eye exam, but each year between 12,000 to 24,000 new cases of blindness occur from diabetic retinopathy. Diabetic retinopathy is caused by changes in the blood vessels in the eye and can be detected and treated through annual dilated eye exams and procedures like laser surgery. Maintaining good control of blood sugar and receiving regular eye exams can help reduce the risk of vision loss from diabetic eye disease.
Diabetic Retinopathy
1. Diabetic retinopathy is a microvascular complication of diabetes that affects the small blood vessels in the retina and is a leading cause of blindness.
2. Early changes include loss of retinal pericytes, thickening of capillary basement membranes, and formation of microaneurysms. Later stages involve proliferative retinopathy and macular edema.
3. Risk factors include duration of diabetes, poor blood glucose control, hypertension, and nephropathy. Tight control of blood glucose and blood pressure can help reduce the risk and progression of diabetic retinopathy.
Dr screening training for nurses 3 b-diabetic retinopathy
Diabetic retinopathy is a complication of diabetes that affects the retina. It begins as non-proliferative retinopathy and can progress to proliferative retinopathy, causing new blood vessels to form that can bleed. Macular edema is swelling of the macula and a leading cause of vision loss. Screening is important as early treatment with laser therapy can prevent vision loss. Intensive control of blood sugar, blood pressure, and lipids can reduce the risk and progression of retinopathy.
Diabetic retinopathy (opthalmology)
Diabetic retinopathy is a complication of diabetes mellitus where changes occur in the retina. It is a leading cause of vision loss among working age adults in Malaysia. The risk of retinopathy rises with longer duration of diabetes and poor blood glucose control. Annual eye screening is recommended to detect early signs and plan treatment. Laser photocoagulation is commonly used to treat early stages while vitrectomy may be used for advanced proliferative cases with vitreous hemorrhage. Anti-VEGF drugs combined with laser can also treat diabetic macular edema.
Ocular Hypertension
This document discusses ocular hypertension. It begins by defining ocular hypertension and noting that distinguishing it from early glaucoma can be difficult. It then discusses the epidemiology, risk factors, diagnosis, investigations, treatment, and the Ocular Hypertension Treatment Study (OHTS). The OHTS was a landmark study that showed topical ocular hypotensive medication can delay or prevent the onset of glaucoma in patients with ocular hypertension. It identified several risk factors for progression to glaucoma, including older age, higher eye pressure, larger optic discs, thinner corneas, and abnormal visual fields.
Diabetic retinopathy
This condition name “Diabetic retinopathy” is characterized by damage to the retina caused by severe complications of diabetes mellitus. Diabetic retinopathy can lead to blindness if not treated on time. It is possible to prevent early blindness because of diabetic retinopathy with the help of routine checks and effective management of underlying diabetes.
Diabetic Retinopathy
Diabetic retinopathy is progressive dysfunction of retinal blood vessels due to hyperglycemia. It is the leading cause of blindness among working-age adults. The risk increases with duration of diabetes and is also increased by hypertension, smoking, and renal disease. Early stages are asymptomatic but can progress to proliferative diabetic retinopathy with neovascularization, potentially leading to vitreous hemorrhage or retinal detachment. Treatment depends on severity and may include laser photocoagulation, intravitreal injections, or vitrectomy surgery. Regular screening is important to detect diabetic retinopathy early and prevent vision loss.
Diabetic Retinopathy
Diabetic retinopathy is the most common
diabetic eye disease and a leading cause of blindness in American adults. It is
caused by changes in the blood vessels of the retina.
In some people with diabetic retinopathy,
blood vessels may swell and leak fluid. In other people, abnormal new blood
vessels grow on the surface of the retina. The retina is the light-sensitive
tissue at the back of the eye. A healthy retina is necessary for good vision.
If you have diabetic retinopathy, at
first you may not notice changes to your vision. But over time,
diabetic retinopathy can get worse and cause vision loss. Diabetic
retinopathy usually affects both eyes.
Ocular Manifestation of Diabetes Mellitus
The document summarizes key points from a conference on diabetes and insulin. It discusses the various ocular manifestations of diabetes, including retinopathy, neuropathy, glaucoma and cataracts. It notes that up to 95% of those with type 1 diabetes and 60% of those with type 2 diabetes develop retinopathy. Risk factors include blood sugar levels, blood pressure, duration of diabetes, blood lipids, ethnicity and pregnancy. Screening guidelines are provided based on diabetes type and risk level. Imaging techniques like OCT and treatments like anti-VEGF injections plus laser therapy are reviewed. Novel research areas are also highlighted.
Diabetic retinopathy
This document discusses diabetic retinopathy (DR), a complication of diabetes that can lead to blindness. It defines DR and outlines its prevalence, risk factors, signs and symptoms, pathogenesis, grading scales, screening recommendations, treatment approaches, and criteria for referral. DR affects the small blood vessels in the retina and ranges from mild non-proliferative DR to more severe proliferative DR. Screening is crucial and treatment depends on the stage, with options like laser therapy and intraocular injections.
Non Proliferative Diabetic Retinopathy
This document provides information on non-proliferative diabetic retinopathy (NPDR), including:
1. It discusses the pathogenesis, risk factors, signs and symptoms, classifications, and treatment of NPDR. The main causes of NPDR are changes to the retinal capillaries due to effects of hyperglycemia.
2. Signs of NPDR include microaneurysms, hemorrhages, exudates, cotton wool spots, venous changes, and macular edema. Treatment focuses on glycemic control and may include laser therapy or anti-VEGF injections.
3. Regular eye exams are recommended for diabetic patients to monitor for retinopathy, as early treatment can help prevent
Diabetic retinopathy
Diabetic retinopathy - introduction,type, risk factors, etdrs classification, airlie classification , diabetic macular edema, dme treatment, diabetic retinopathy screening, diabetic retinopathy studies , diabetic retinopathy treatment, anti-vegf injections
Diabetic retinopathy
This document discusses diabetic retinopathy and its effects on the eye. It begins by outlining the various parts of the eye that can be affected by diabetes, including the lids, conjunctiva, cornea, iris, angle, lens, vitreous, retina, optic nerve, and sixth nerve. It then focuses on diabetic retinopathy, explaining that it has no initial symptoms, screening is important, and that intensive therapy and good blood glucose control can slow its progression. The document also describes treatments like laser therapy to preserve vision. It emphasizes that nearly all people with diabetes will develop some retinopathy and regular screening is needed to catch and treat it early.
Diabetic Retinopathy
Diabetic retinopathy is a disease that damages the blood vessels of the light-sensitive tissue at the back of the eye (the retina). It is the leading cause of blindness among American adults aged 20-74. Nearly half of all diabetics have some signs of retinopathy. Early detection and treatment can help prevent vision loss from the disease. Controlling blood sugar levels, laser treatments, and vitrectomy surgery are common treatments used to manage diabetic retinopathy.
Diabetic retinopathy
Diabetic retinopathy is a complication of diabetes, caused by high blood sugar levels damaging the back of the eye (retina). It can cause blindness if left undiagnosed and untreated. However, it usually takes several years for diabetic retinopathy to reach a stage where it could threaten your sight.
The retina is the light-sensitive layer of cells at the back of the eye that converts light into electrical signals. The signals are sent to the brain which turns them into the images you see.
The retina needs a constant supply of blood, which it receives through a network of tiny blood vessels. Over time, a persistently high blood sugar level can damage these blood vessels in 3 main stages:
background retinopathy – tiny bulges develop in the blood vessels, which may bleed slightly but don't usually affect your vision
pre-proliferative retinopathy – more severe and widespread changes affect the blood vessels, including more significant bleeding into the eye
proliferative retinopathy – scar tissue and new blood vessels, which are weak and bleed easily, develop on the retina, this can result in some loss of vision
Diabetic retinopathy- Management
This document discusses diabetic retinopathy, including:
- DR is a major cause of blindness and is classified as non-proliferative or proliferative.
- Tight control of blood glucose, blood pressure, and lipids can slow progression of DR.
- Laser photocoagulation is effective for treating diabetic macular edema and proliferative DR. Focal laser is used for edema localized to the macula, while panretinal photocoagulation scatters wider burns throughout the retina to induce regression of new vessels.
- Imaging like OCT and fluorescein angiography help diagnose and monitor DR and guide treatment.
Biomarkers of diabetic retinopathy
This document presents information on diabetic retinopathy including its causes, risk factors, stages, diagnosis, and treatment. It begins with an introduction by Sonali Diwate and objectives of the presentation. It then outlines the topics to be discussed and provides details on the types and pathogenesis of diabetic retinopathy. The stages of diabetic retinopathy from mild nonproliferative to proliferative are explained. Risk factors, diagnostic tests, management approaches like laser therapy and anti-VEGF injections, potential biomarkers and conclusions are summarized. The document aims to raise awareness of diabetic retinopathy as a public health problem and discuss treatments and management of the disease.
Diabetic retinopathy and Hallmark studies
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Diabetic retinopathy
This document discusses diabetic retinopathy (DR), the leading cause of blindness among working-age adults. It provides guidelines for screening and grading DR based on findings during eye examinations. DR results from prolonged hyperglycemia and increases in severity over time. Regular screening can detect DR early and prevent vision loss through timely treatment. Examiners should grade DR based on lesions seen and refer patients accordingly, from annual follow-up for mild cases to urgent referral within a week for advanced proliferative DR or other high-risk findings. Strict glycemic control remains the primary approach for preventing and slowing the progression of DR.
Diabetic retinopathy
Diabetic retinopathy is caused by damage to the blood vessels in the retina from chronic hyperglycemia. It is the most common retinal vascular disease and a leading cause of vision loss. The risk and severity of diabetic retinopathy increases with longer duration of diabetes, poorer blood glucose control, and presence of other complications like hypertension. The pathogenesis involves microvascular changes like capillary non-perfusion and death of pericytes, as well as increased vascular permeability and neo-vascularization due to elevated levels of vasoactive growth factors. Strict control of blood glucose and other cardiovascular risk factors can help prevent and slow the progression of this vision-threatening condition.
Diabetic Retinopathy
Diabetic retinopathy is a progressive microangiopathy caused by damage and occlusion of pre-capillary, capillaries and post-capillary venules due to diabetes. Risk factors include duration of diabetes, poor metabolic control, pregnancy, hypertension, nephropathy, and others like hypercholesterolemia, smoking and obesity. It progresses through preproliferative, proliferative stages and can cause macular edema or retinal neovascularization leading to vision loss. Detection involves comprehensive eye exams including visual acuity and retinal imaging tests like fluorescein angiography and optical coherence tomography.
Diabetic retinopathy
Diabetic retinopathy is a disease of the retina caused by diabetes. It progresses through three stages defined by pathological changes: no retinopathy, non-proliferative retinopathy, and proliferative retinopathy. In non-proliferative retinopathy, microaneurysms and vascular leakage occur. Proliferative retinopathy is characterized by the growth of abnormal blood vessels driven by ischemia. Treatment depends on the stage, ranging from blood sugar control and exams to anti-VEGF drugs and laser photocoagulation to halt disease progression and complications like vitreous hemorrhaging.
Diabetic retinopathy
Diabetic retinopathy is caused by chronic hyperglycemia resulting in damage to the retinal vasculature. Prolonged diabetes duration increases risk, with over 95% of type 1 diabetics affected after 20-30 years. Tight blood sugar control can significantly reduce risk and progression as shown in the DCCT trial. Proliferative diabetic retinopathy involves the growth of new blood vessels on the retina or optic disc which can lead to vision loss from vitreous hemorrhage or retinal detachment. Laser photocoagulation treatment can help reduce this risk by decreasing retinal ischemia.
Childhood VKH
This case presentation describes a 13-year-old female patient with diminished vision in both eyes for 6 months. She has a history of cataract surgery 2 months prior. On examination, she has uveitis, complicated cataracts, and vitreous opacity in both eyes. Based on her clinical features and investigations, she is diagnosed with Vogt-Koyanagi-Harada syndrome. She is started on high-dose intravenous steroids followed by oral steroids and immunosuppressants. Her vision improves but remains diminished at the time of discharge. Vogt-Koyanagi-Harada syndrome is a rare autoimmune condition affecting multiple organs including the eyes, skin, and central nervous
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This document discusses ocular hypertension. It begins by defining ocular hypertension and noting that distinguishing it from early glaucoma can be difficult. It then discusses the epidemiology, risk factors, diagnosis, investigations, treatment, and the Ocular Hypertension Treatment Study (OHTS). The OHTS was a landmark study that showed topical ocular hypotensive medication can delay or prevent the onset of glaucoma in patients with ocular hypertension. It identified several risk factors for progression to glaucoma, including older age, higher eye pressure, larger optic discs, thinner corneas, and abnormal visual fields.
Diabetic retinopathy
This condition name “Diabetic retinopathy” is characterized by damage to the retina caused by severe complications of diabetes mellitus. Diabetic retinopathy can lead to blindness if not treated on time. It is possible to prevent early blindness because of diabetic retinopathy with the help of routine checks and effective management of underlying diabetes.
Diabetic Retinopathy
Diabetic retinopathy is progressive dysfunction of retinal blood vessels due to hyperglycemia. It is the leading cause of blindness among working-age adults. The risk increases with duration of diabetes and is also increased by hypertension, smoking, and renal disease. Early stages are asymptomatic but can progress to proliferative diabetic retinopathy with neovascularization, potentially leading to vitreous hemorrhage or retinal detachment. Treatment depends on severity and may include laser photocoagulation, intravitreal injections, or vitrectomy surgery. Regular screening is important to detect diabetic retinopathy early and prevent vision loss.
Diabetic Retinopathy
Diabetic retinopathy is the most common
diabetic eye disease and a leading cause of blindness in American adults. It is
caused by changes in the blood vessels of the retina.
In some people with diabetic retinopathy,
blood vessels may swell and leak fluid. In other people, abnormal new blood
vessels grow on the surface of the retina. The retina is the light-sensitive
tissue at the back of the eye. A healthy retina is necessary for good vision.
If you have diabetic retinopathy, at
first you may not notice changes to your vision. But over time,
diabetic retinopathy can get worse and cause vision loss. Diabetic
retinopathy usually affects both eyes.
Ocular Manifestation of Diabetes Mellitus
The document summarizes key points from a conference on diabetes and insulin. It discusses the various ocular manifestations of diabetes, including retinopathy, neuropathy, glaucoma and cataracts. It notes that up to 95% of those with type 1 diabetes and 60% of those with type 2 diabetes develop retinopathy. Risk factors include blood sugar levels, blood pressure, duration of diabetes, blood lipids, ethnicity and pregnancy. Screening guidelines are provided based on diabetes type and risk level. Imaging techniques like OCT and treatments like anti-VEGF injections plus laser therapy are reviewed. Novel research areas are also highlighted.
Diabetic retinopathy
This document discusses diabetic retinopathy (DR), a complication of diabetes that can lead to blindness. It defines DR and outlines its prevalence, risk factors, signs and symptoms, pathogenesis, grading scales, screening recommendations, treatment approaches, and criteria for referral. DR affects the small blood vessels in the retina and ranges from mild non-proliferative DR to more severe proliferative DR. Screening is crucial and treatment depends on the stage, with options like laser therapy and intraocular injections.
Non Proliferative Diabetic Retinopathy
This document provides information on non-proliferative diabetic retinopathy (NPDR), including:
1. It discusses the pathogenesis, risk factors, signs and symptoms, classifications, and treatment of NPDR. The main causes of NPDR are changes to the retinal capillaries due to effects of hyperglycemia.
2. Signs of NPDR include microaneurysms, hemorrhages, exudates, cotton wool spots, venous changes, and macular edema. Treatment focuses on glycemic control and may include laser therapy or anti-VEGF injections.
3. Regular eye exams are recommended for diabetic patients to monitor for retinopathy, as early treatment can help prevent
Diabetic retinopathy
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Diabetic retinopathy
This document discusses diabetic retinopathy and its effects on the eye. It begins by outlining the various parts of the eye that can be affected by diabetes, including the lids, conjunctiva, cornea, iris, angle, lens, vitreous, retina, optic nerve, and sixth nerve. It then focuses on diabetic retinopathy, explaining that it has no initial symptoms, screening is important, and that intensive therapy and good blood glucose control can slow its progression. The document also describes treatments like laser therapy to preserve vision. It emphasizes that nearly all people with diabetes will develop some retinopathy and regular screening is needed to catch and treat it early.
Diabetic Retinopathy
Diabetic retinopathy is a disease that damages the blood vessels of the light-sensitive tissue at the back of the eye (the retina). It is the leading cause of blindness among American adults aged 20-74. Nearly half of all diabetics have some signs of retinopathy. Early detection and treatment can help prevent vision loss from the disease. Controlling blood sugar levels, laser treatments, and vitrectomy surgery are common treatments used to manage diabetic retinopathy.
Diabetic retinopathy
Diabetic retinopathy is a complication of diabetes, caused by high blood sugar levels damaging the back of the eye (retina). It can cause blindness if left undiagnosed and untreated. However, it usually takes several years for diabetic retinopathy to reach a stage where it could threaten your sight.
The retina is the light-sensitive layer of cells at the back of the eye that converts light into electrical signals. The signals are sent to the brain which turns them into the images you see.
The retina needs a constant supply of blood, which it receives through a network of tiny blood vessels. Over time, a persistently high blood sugar level can damage these blood vessels in 3 main stages:
background retinopathy – tiny bulges develop in the blood vessels, which may bleed slightly but don't usually affect your vision
pre-proliferative retinopathy – more severe and widespread changes affect the blood vessels, including more significant bleeding into the eye
proliferative retinopathy – scar tissue and new blood vessels, which are weak and bleed easily, develop on the retina, this can result in some loss of vision
Diabetic retinopathy- Management
This document discusses diabetic retinopathy, including:
- DR is a major cause of blindness and is classified as non-proliferative or proliferative.
- Tight control of blood glucose, blood pressure, and lipids can slow progression of DR.
- Laser photocoagulation is effective for treating diabetic macular edema and proliferative DR. Focal laser is used for edema localized to the macula, while panretinal photocoagulation scatters wider burns throughout the retina to induce regression of new vessels.
- Imaging like OCT and fluorescein angiography help diagnose and monitor DR and guide treatment.
Biomarkers of diabetic retinopathy
This document presents information on diabetic retinopathy including its causes, risk factors, stages, diagnosis, and treatment. It begins with an introduction by Sonali Diwate and objectives of the presentation. It then outlines the topics to be discussed and provides details on the types and pathogenesis of diabetic retinopathy. The stages of diabetic retinopathy from mild nonproliferative to proliferative are explained. Risk factors, diagnostic tests, management approaches like laser therapy and anti-VEGF injections, potential biomarkers and conclusions are summarized. The document aims to raise awareness of diabetic retinopathy as a public health problem and discuss treatments and management of the disease.
Diabetic retinopathy and Hallmark studies
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Introduction, classification, clinical features, Diabetic macular edema, diagnosis, examination, investigations, management, hallmark studies.
Dry Eye and Ocular surface diseases in diabetes mellitus
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Diabetic retinopathy
This document discusses diabetic retinopathy (DR), the leading cause of blindness among working-age adults. It provides guidelines for screening and grading DR based on findings during eye examinations. DR results from prolonged hyperglycemia and increases in severity over time. Regular screening can detect DR early and prevent vision loss through timely treatment. Examiners should grade DR based on lesions seen and refer patients accordingly, from annual follow-up for mild cases to urgent referral within a week for advanced proliferative DR or other high-risk findings. Strict glycemic control remains the primary approach for preventing and slowing the progression of DR.
Diabetic retinopathy
Diabetic retinopathy is caused by damage to the blood vessels in the retina from chronic hyperglycemia. It is the most common retinal vascular disease and a leading cause of vision loss. The risk and severity of diabetic retinopathy increases with longer duration of diabetes, poorer blood glucose control, and presence of other complications like hypertension. The pathogenesis involves microvascular changes like capillary non-perfusion and death of pericytes, as well as increased vascular permeability and neo-vascularization due to elevated levels of vasoactive growth factors. Strict control of blood glucose and other cardiovascular risk factors can help prevent and slow the progression of this vision-threatening condition.
Diabetic Retinopathy
Diabetic retinopathy is a progressive microangiopathy caused by damage and occlusion of pre-capillary, capillaries and post-capillary venules due to diabetes. Risk factors include duration of diabetes, poor metabolic control, pregnancy, hypertension, nephropathy, and others like hypercholesterolemia, smoking and obesity. It progresses through preproliferative, proliferative stages and can cause macular edema or retinal neovascularization leading to vision loss. Detection involves comprehensive eye exams including visual acuity and retinal imaging tests like fluorescein angiography and optical coherence tomography.
Diabetic retinopathy
Diabetic retinopathy is a disease of the retina caused by diabetes. It progresses through three stages defined by pathological changes: no retinopathy, non-proliferative retinopathy, and proliferative retinopathy. In non-proliferative retinopathy, microaneurysms and vascular leakage occur. Proliferative retinopathy is characterized by the growth of abnormal blood vessels driven by ischemia. Treatment depends on the stage, ranging from blood sugar control and exams to anti-VEGF drugs and laser photocoagulation to halt disease progression and complications like vitreous hemorrhaging.
Diabetic retinopathy
Diabetic retinopathy is caused by chronic hyperglycemia resulting in damage to the retinal vasculature. Prolonged diabetes duration increases risk, with over 95% of type 1 diabetics affected after 20-30 years. Tight blood sugar control can significantly reduce risk and progression as shown in the DCCT trial. Proliferative diabetic retinopathy involves the growth of new blood vessels on the retina or optic disc which can lead to vision loss from vitreous hemorrhage or retinal detachment. Laser photocoagulation treatment can help reduce this risk by decreasing retinal ischemia.
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- 1. CASE PRESENTATION : OPTIC DISC MELANOCYTOMA Dr. Arup Krishna Choudhury FCPS, DO, MBBS Vitreo-Retina Fellow ( IIEI&H)
- 2. PATIENT PARTICULARS • Name: Y • Age: 18 years • Sex: Male • Occupation: Student • Address : Mirpur, Dhaka
- 3. CHIEF COMPLAINTS • Blurring of vision in right eye for 7 days • Seeing of black spot in right eye for same duration
- 4. HISTORY OF PRESENT ILLNESS • According to patients statement he noticed blurring of vision and floaters in his right eye for 7 days. Onset was sudden, progressive in nature and not associated with any pain or redness • No history of trauma, systemic illness and drugs
- 5. GENERAL EXAMINATION • Appearance: Ill looking • Body built: Average • Pulse: 74/min • BP: 120/70 mm of Hg • Respiratory rate: 14/min • Temperature: 97⁰F • Anaemia: Absent • Jaundice: Absent • Cyanosis: Absent • Oedema: Absent
- 6. SYSTEMIC EXAMINATION Respiratory System: NAD CVS: NAD Nervous System: NAD
- 7. OCULAR EXAMINATION VA RE LE Unaided 6/18P 6/6P Aided NI (-1.0/-0.50/180⁰) 6/6 (-0.50) Near N10 N6
- 8. OCULAR EXAMINATION RE LE Eye lid Normal Normal Conjunctiva Normal Normal Cornea Clear Clear A/C Normal Normal Pupil RRR RRR Lens Clear Clear Anterior Vitreous Cells Normal IOP 12 mm of Hg 12 mm of Hg
- 9. FUNDUS EXAMINATION RE LE Media Clear Clear Optic disc Pigmented dark elevated lesion over the disc Size , Shape & Color normal. CD – 04 : 1 Macula Exudates resembling Star NAD
- 10. DIAGNOSIS Optic Disc Melanocytoma with macular oedema of Right Eye
- 11. DIFFERENTIAL DIAGNOSIS Choroidal Nevus Choroidal Melanoma
- 12. INVESTIGATIONS Colour Fundus Photography OCT Angiogram B-Scan
- 14. OCT-A
- 15. B- SCAN
- 16. TREATMENT Tab. Prednisolone 20 mg Tab. Esomeprazole 20 mg
- 17. CFP After 1 month of treatment VA: 6/6P
- 19. DISCUSSION KEY FACTS : • Rare unilateral heavily pigmented hamartoma, seen most frequently at the optic nerve head but may involve the adjacent retina and choroid • Benign tumor, very rarely malignant ( 1-2%) • Congenital and non-hereditary lesion • No sexual predilection
- 20. HISTOPATHOLOGY : • Histopathologically composed of highly pigmented round cells with cytoplasmic melanosomes • Cells are of low nuclear-to-cytoplasmic ratio
- 21. DIAGNOSIS : SYMPTOMS : • Usually asymptomatic and stable • However, visual symptoms are associated with exudation with foveal involvement or other complications CLINICAL FINDINGS : • Dark brown or black, flat or slightly elevated lesion with feathery edges • RAPD may be present, even if VA is good
- 22. INVESTIGATIONS : COLOUR FUNDUS PHOTOGRAPHY : Documentation of lesion to monitor for growth FLUORESCEIN ANGIOGRAPHY : Hypofluorescent , which differentiates melanocytoma from malignant melanoma
- 23. B-SCAN : A dome-shaped appearance is a frequent feature in melanocytoma, and its high internal echogenicity indicates a benign lesion OPTICAL COHERENCE TOMOGRAPHY (OCT) : Nodular elevation with dense posterior shadowing
- 24. OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY (OCT-A) : • To visualize capillaries on the tumor surface • To determine the tumor's depth • Quantification of the microvascular flow rate • Identification of progression VISUAL FIELD : To evaluate for defects secondary to compression of optic disc
- 25. SYSTEMIC ASSOCIATIONS : • Usually isolated condition • But some studies suggest association with neurofibromatosis type 2, basal cell carcinoma, vitiligo & hypertension
- 26. COMPLICATIONS : • Malignant transformation • Spontaneous necrosis • Optic nerve compression • Retinal vein obstruction • Intraretinal edema and subretinal fluid • Yellow intraretinal exudation • Focal hemorrhage and vitreous seeds
- 27. TREATMENT : • Observation • Clinical and imaging follow-up should be performed annually PROGNOSIS : Vast majority of cases remains stable and do not lead to visual impairment
- 28. TAKE HOME MESSAGE • Optic disk melanocytoma is a benign neoplasm • Seldom exhibits malignant transformation • Nevertheless, it can show growth and several complications • Annual follow up with CFP & OCT should be considered
- 29. REFERENCES 1. Kanski's clinical ophthalmology : a systematic approach. [Brad Bowling; Jack J Kanski] 2. American Academy of Ophthalmology 3. Rapid Diagnosis in Ophthalmology Series: Retina 4. EyeWiki
- 30. THANK YOU