Background Diabetic Retinopathy (BDR) |
- Microaneurysms in retinal blood vessels.
- Retinal haemorrhages or exudates may be present.
- Retinal exam using fundus photography or slit-lamp biomicroscopy.
- No visual symptoms in early stages.
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- Glycaemic Control: Tight control of blood glucose levels (HbA1c target < 7%).
- Blood Pressure Control: Maintain BP < 140/90 mmHg.
- Annual Eye Examination: Regular follow-ups with an ophthalmologist to monitor progression.
- Lifestyle Modifications: Smoking cessation, weight management, and regular exercise.
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Non-Proliferative Diabetic Retinopathy (NPDR) |
- More extensive microaneurysms, dot and blot haemorrhages, and cotton wool spots.
- Venous beading and intraretinal microvascular abnormalities (IRMA) may be present.
- Fluorescein angiography may be used to assess retinal blood flow.
- Retinal exam with optical coherence tomography (OCT) to evaluate for macular edema.
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- Strict Glycaemic Control: HbA1c < 7% to reduce progression.
- Treat Macular Edema: Intravitreal injections of anti-VEGF agents (e.g., bevacizumab, ranibizumab) or corticosteroids.
- Laser Photocoagulation: Focal or grid laser therapy for clinically significant macular edema (CSME).
- Regular Monitoring: Eye exams every 3-6 months depending on the severity.
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Proliferative Diabetic Retinopathy (PDR) |
- Neovascularization of the retina or optic disc.
- Fibrous tissue proliferation, which can lead to tractional retinal detachment.
- Vitreous haemorrhage may occur, causing sudden vision loss.
- Retinal examination and OCT to assess retinal traction and neovascularization.
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- Panretinal Photocoagulation (PRP): Laser treatment to regress neovascularization.
- Anti-VEGF Therapy: Intravitreal injections to reduce neovascularization and macular edema.
- Vitrectomy: Surgical intervention for vitreous haemorrhage or retinal detachment.
- Frequent Monitoring: Eye exams every 3 months or as advised by an ophthalmologist.
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Diabetic Macular Edema (DME) |
- Thickening of the macula due to fluid leakage from damaged retinal vessels.
- Blurry or distorted central vision.
- OCT to measure macular thickness and detect fluid accumulation.
- Fluorescein angiography to identify areas of vascular leakage.
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- Intravitreal Anti-VEGF Therapy: Injections (e.g., ranibizumab, aflibercept) to reduce macular swelling.
- Intravitreal Corticosteroids: For patients unresponsive to anti-VEGF therapy.
- Laser Photocoagulation: Focal or grid laser treatment for focal DME.
- Monitoring: Regular follow-up with OCT to monitor response to treatment.
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Advanced Diabetic Eye Disease |
- Severe complications such as tractional retinal detachment or recurrent vitreous haemorrhage.
- Significant vision loss or blindness.
- Assessment with OCT, retinal photography, and fluorescein angiography.
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- Vitrectomy Surgery: For retinal detachment, persistent vitreous haemorrhage, or advanced tractional membranes.
- Continued Anti-VEGF Therapy: To reduce further neovascularization.
- Long-Term Monitoring: Regular ophthalmologic follow-up to prevent further complications.
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