Overview

• Eventually occurs in some degree in all patients with DM
• Two types → Non-Proliferative (early stage, less severe) and Proliferative (more advanced)
• Most common cause of visual impairment and blindness in patients aged 25-74 years old
• Background Retinopathy → Pre-Proliferative Retinopathy → Proliferative Retinopathy (Also Maculopathy)

Making Diagnosis

Clinical Features:

• Asymptomatic until very late stages of disease
• Visual impairment → Progression to blindness
• Non-Proliferative (NPDR) → Microaneurysms, Cotton Wool spots, Blot Haemorrhages, Hard Exudates
• Proliferative (PDR) → findings of NPDR usually present. Also see retinal neovascularization and retinal detachment
• Maculopathy → changes occur on macula

Complete loss of vision ⇒ due to retinal detachment or vitreous haemorrhage

• Retinal Detachment → sudden painless loss of vision, dense shadow starting peripherally and progressing centrally. Patient may also experience flashers or floaters.
• Vitreous Haemorrhage → bleeding into vitreous humour. Sudden appearance of spots or floaters in your vision to cause a sudden blurring of vision but does not cause flashing lights seen in retinal detachment. May complain of dark spots in their vision.

Investigations: