Endocrine » Diabetes

Diabetic Retinopathy

Retinopathy, a microvascular complication of diabetes, leads to blindness in the patient. Good glycaemic control and early referral to the ophthalmologist can prevent this complication. The main pathophysiology is endothelial damage and focal capillary occlusion leading to retinal ischemia. Micro aneurysms cotton wool spots, retinal haemorrhages, detachment, macular edema neovascular glaucoma rubeosis iridis may be seen depending on the stage of retinopathy. Duration of disease, renal disease, systemic hypertension, hyperlipaedimia and smoking correlate well as predictors of the disease. Yearly fundus exam by ophthalmologist is an effective screening procedure. Investigations include Fluorescein angiography and B scan. Management includes Glucose control and focal laser photocoagulation. The fundi of all diabetics must be examined regularly; preferably with fundus photography.

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