Test Your Diabetic Retinopathy Knowledge! Trivia Quiz

HgA1C

Duration

Ethnicity

Co-morbidity with Glaucoma

Diabetics are prone to cranial nerve palsies therefore EOMs are a useful test

IOPs help rule out POAG and neovascular glaucoma

Pan retinal photocoagulation is usually used to treat the midperiphery, this treatment is required before CSME can be treated on a diabetic

Additional treatments for Diabetic retinopathy include using a focal and grid laser as well as a vitrectomy and ILM strip

Hyperperfusion and edema

Neovascularization and pericyte degeneration

Hypoxia and edema

Vasodilation and basement membrane thickening

Breakdown of the blood retina barrier

Refer the patient to their PCP for better control of their diabetes as indicated by the PDR in their OD eye

Refer to their PCP for a possible carotid artery stenosis on their OS side.

Refer the patient to an OMD for PRP or laser Tx on their OD eye

Tell the patient their OS eye is doing well but their OD eyes is showing signs of their diabetes indicating they need better blood sugar control

Neovascularization then macular edema

Macular edema then Neovascularization

They both require PRP for treatment so they can be treated at the same time

You can treat the neovascularization after the macular edema has resolved on it's own

If the pt has a really dense cataract, PRP is always done before the cataract surgery because cataract surgery creates a lot of inflammation.

• PRP it shouldn’t be done anywhere in the vicinity of 2dd of the macula. • It also shouldn’t be 500microns from the nasal aspect of the nerve head.

Hemes will hyperfluress on a FA because they will block the fluorescein.

Typically a surgeon wont do a lot of PRP on one visit. They will break it up to 2-3 sessions of PRP within a few weeks to avoid ciliochoroidal effusion.

Flame hemes are located in the RNFL, dot blot hemes are located in the inner nuclear/outer plexiform layer.

Intra-retinal microvascular abnormalities will often leak on an FA. It will also grow towards the vitreous and goes across both arteries and veins.

Cotton Wool Spots an appear similar to RNFL myelination the can be differentiated from one another by proximity to optic nerve, the presence of striations and whether or not it is long standing

In order to diagnose severe nonproliferative diabetic retinopathy you need to have 4 quadrants of severe hemorrhaging, 2 quadrants of venous beading and 1 large area of IRMA. You typicall need to see 2 or more of these to be considered severe

Venous beading is the highest predictor that a patient is going to convert to proliferative diabetic ret.

Joins obstructed veins to non-obstructed veins and obstructed arteries to non-obstructed arteries.

Connect the central retinal vein to the choroidal veins. It occurs when retinal venous circulation is compromised

Often lead in outer plexiform and inner nuclear layers

Are composed of lipids and originate in the outer plexiform layer

Retinal thickening greater than 1DD within 1DD of the macula.

Exudates at or within 500 microns of the macula

Retinal thickening at or within 500microns of the macula.

Exudates at or within 500 microns of the macula with associated retinal thickening.

Circinate ring

Decreased VAs and papilledema

Focal or diffuse edema without exudates

Macular edema with a tractional component

Focal laser

PRP

Grid laser

Kenalog injection

If you have dot blot hemes you’re gonna get a HYPOfluorescence. It’s going to be dark, and block the fluorescein

Leakage such as edema or neovascularization will cause HYPERfluorescence at the beginning of the FA, and as time goes on, 5 minutes, 10 minutes, that amount of leaking is going to grow in size and intensity because it keeps leaking.

Cotton wool spots you’re going to have HYPOfluorescence because they’re areas of non-perfusion

Microaneurysms will have Hypofluorescence

Fibrovascular proliferation can cause a tractional RD. It can do other things like distort the retina and optic nerve by dragging it. It can also create vitreal hemorrhages becauseit is tugging on a vessel or neo. It can also create a macular hole.

Pre-retinal heme or a intra-vitreal heme indicates that you have proliferative DR, even if you can’t see neo.

There are 3 main types of hemorrhages. There is (1) Intra-retinal (dot or blot heme) (2) Pre-retinal (between retina and posterior hyaloid face of vitreous) (3) Intra-vitreal hemorrhage (inside the vitreous).

Unlike CSME, Diabetic Papillopathy can not happen at any stage of diabetic retinopathy. It typically occurs at high risk severe diabetic retinopathy.

NVI originates when the retina becomes so ischemic, the angiogenic factors have no way to be transported, so they move towards the front of the eye. The angiogenic factors will go into the vitreous and into the AC and will bathe the aqueous and iris

Are due to a complication with vitrectomy

If seen in diabetics, it represents more of acute change. It’s typically not something you see in pts that have good control or just constantly elevated sugar.

Are typically seen in people with a history of Hep C

Is common in sickle cell retinopathy

Sickle cell retinopathy

Interferon Retinopathy

Ocular Ischemic syndrome

Eale's Disease

Antiphospholipid syndrome

Purtscher's Retinopathy