Test Your Diabetic Retinopathy Knowledge! Trivia Quiz

Proliferative diabetic retinopathy is more prevalent in patients who have had diabetes for a longer duration and who are on insulin. This form of diabetic retinopathy is characterized by the growth of abnormal blood vessels in the retina, which can lead to vision loss if left untreated. Treatment is necessary to prevent further complications and manage the condition effectively.

Optociliary shunt vessels are formed when there is a compromise in the retinal venous circulation. These vessels connect the central retinal vein to the choroidal veins. They do not join obstructed veins to non-obstructed veins or obstructed arteries to non-obstructed arteries. Optociliary shunt vessels are often seen in the outer plexiform and inner nuclear layers and are composed of lipids.

The statement is true because the procedures mentioned (focal/grid, vitrectomy, ILM strip) can indeed be done for macular edema. Additionally, the procedures mentioned (PRP, vitrectomy, ILM strip) can also be done for neo (neovascularization). Therefore, both statements are accurate and the answer is true.

Focal and grid laser -you’re essentially trying to seal off the leaking

The number one risk factor for the development of diabetic retinopathy is duration. This means that the longer a person has diabetes, the higher their risk of developing this eye condition. Diabetic retinopathy is a complication of diabetes that affects the blood vessels in the retina, leading to vision problems and potentially even blindness. The longer a person has diabetes, the more likely they are to experience damage to their blood vessels, increasing their risk of developing diabetic retinopathy.

Diabetic retinopathy is a condition that occurs due to damage to the blood vessels in the retina caused by diabetes. Hypoxia, which refers to a lack of oxygen supply to the tissues, is a major factor in the development of diabetic retinopathy. When the blood vessels in the retina are damaged, it can lead to inadequate oxygen supply to the retinal tissues, resulting in hypoxia. Edema, which is the accumulation of fluid in the tissues, is another event that occurs in diabetic retinopathy. The damaged blood vessels can leak fluid into the surrounding tissues, causing edema. Therefore, the combination of hypoxia and edema plays a significant role in the development of diabetic retinopathy.

Need to treat CSME first!!!

Exudates by themselves may not mean there’s active leaking there. It could just mean that they may have had edema at some point, but now there resolved and there’s just edema. Having exudates there alone by themselves doesn’t necessarily mean they have edema there.

Diabetic ret should typically be bilateral. If you see one eye that has nothing and the other eye has moderate you know there is probably some type of carotid occlusion on the side without diabetic ret.

The first line of treatment for neo is PRP. The first line for macular edema is focal or grid laser. Kenalog injection/steroids done if the focal injection is not effective or if there’s way too much edema.

They can definitely have CSME even if they have 20/20. It may be mild, but they can still have CSME. If you think that you see CSME and they see 20/20, they may still have CSME. Again the goal of the treatment isn’t to improve vision but to save vision. If the patient has 20/20 vision that’s great, so you want to preserve that 20/20 vision.

4. Sickle Cell Retinopathy a. Sea-fan neo** – classic sign of Sickle cell b. Black sunbursts – RPE proliferation from deep penetrating hemes c. Salmon patches – fresh blood (intra-retinal) d. Angiod Streaks – Breaks in Bruch’s Membrane (can lead to growth of choroidal vessels into the retinal) e. Hemosiderin patches - patches of extra iron Complications with vitrectomy • Endophthalmitis (infection of posterior chamber). • Cataract, RD from the surgery itself • If they touch the endothelium of the cornea or if there is too much heat during the surgery, it could cause decompensation of the endothelium which can lead to edema. • F/U in 1 day, 1 week, 1 month, 3 months. You are dilating them every time just to make sure things are going ok.

Ciliochoroidal effusion - All of that laser creates edema in between the choroid and the sclera. That is very bad. That creates choroidal detachment, angle-closure and a shallow AC. FA on a pt with MA they are going to light up like a Christmas tree -> later stages of the FA you will see hyperfluorescence because it keeps leaking a little bit. Hemes will hypofluorous on a FA because they will block the fluorescein. Blood will hypofluorous and ME will hyperfluress.

The false statement is "Intra-retinal microvascular abnormalities will often leak on an FA. It will also grow towards the vitreous and goes across both arteries and veins." This statement is incorrect because intra-retinal microvascular abnormalities do not typically leak on a fluorescein angiography (FA) and they do not grow towards the vitreous. They are localized within the retina and can be seen crossing arteries and veins.

ALWAYS tx the macular edema BEFORE the neo. o If a pt has CSME and they have neo, the doctor is always going to do focal laser first to tx the macular edema and then do PRP. The reason is when they do PRP you may be pushing more fluid into the macula. So you want to take care of the edema at the macula first. Vitrectomy can also be done for neo. The reason why is the vitreous plays a big role in angiogenesis and neoformation. By doing a vitrectomy the chances of having neo go down. Focal/grid, vitrectomy, ILM strip can all be done for macular edema. PRP, vitrectomy, ILM strip can be done for neo.

Microaneurysms you’ll have HYPERfluorescence. It’s going to be lighted. There may be some adjacent HYPERfluorescence or leaking.

Retinopathy is a condition that affects the blood vessels in the retina, leading to vision problems or even blindness. Nephropathy, pregnancy, and hypertension are all risk factors for retinopathy. Nephropathy refers to kidney damage, which can cause changes in blood vessels throughout the body, including the retina. Pregnancy can also lead to changes in blood vessels, increasing the risk of retinopathy. Hypertension, or high blood pressure, can damage blood vessels and increase the risk of retinopathy as well. Therefore, these three factors are associated with an increased risk of developing retinopathy.

Diabetic Papillopathy • Unilateral mild ONH edema and is usually unilateral. • Any stage, just like CSME. So you get the signs of disc edema including prominent surface vessels, fine hemorrhages on the disc, cotton wool spots around the disc, indistinct boarders.

Purtscher's retinopathy is the highest on the differential diagnosis because it is characterized by cotton wool spots (CWS) and hemes, which are seen in the patient's BIO evaluation. Additionally, the majority of these findings are located near the optic nerve head (ONH), which is consistent with Purtscher's retinopathy. Sickle cell retinopathy, interferon retinopathy, ocular ischemic syndrome, Eale's disease, and antiphospholipid syndrome may also present with similar findings, but the location of the CWS and hemes near the ONH suggests Purtscher's retinopathy as the most likely diagnosis.

Vessel sheathing - white patch near vessels - associated more with antiphospholipid syndrome

Option 2 : that's what causes vitreal hemorrhages

Option 5: Involutional Proliferative Diabetic Retinopathy.