This document discusses diabetic retinopathy (DR), a complication of diabetes mellitus (DM) characterized by sustained hyperglycemia. Risk factors for DR include duration of DM, poor metabolic control, hypertension, and nephropathy. DR progresses through stages from background DR to proliferative DR. Pathogenesis involves microvascular occlusion and leakage leading to retinal ischemia, neovascularization, and exudation. Late stage complications are diabetic maculopathy and advanced DR with vision-threatening conditions like vitreous hemorrhage.

1. DIABETIC RETINOPATHY
DM is a common metabolic disorder
characterized by sustained
hyperglycemia secondary to lack,
diminished efficacy or both of
endogenous insulin.

2. RISK FACTORS
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Duration of DM
Poor metabolic control
Hypertension
Nephropathy
Pregnancy
Anaemia
Smoking
Obesity
Hyperlipidaemia

3. PATHOGENESIS
 1. Microvascular Occlusion
Capillary changes : Loss of pericytes, thickening of BM
and proliferation of endothelial cells.
Haematological changes : Deformation of RBCs,
increased platelets stickiness & aggregation.
CONSEQUENCES : Retinal ischaemia leading to AV shunts &
neovascularization.

4. PATHOGENESIS
 2. Micro vascular leakage
Breakdown of inner blood-retinal barrier.
CONSEQUENCES : Microaneurism, hard exudates, retinal edema
& hemorrhages.

5. 12.1, 12.2 &12.3

13. 12.83
12.27

15. CLASSIFICATION
 Background DR
 Preproliferative DR
 Proliferative DR
 Diabetic Maculopathy
 Advanced DR

16. Background DR
 Microaneurisms
 Hard exudates
 Retinal edema
 Haemorrhages
 Management

17. Background DR

18. Background DR

19. Preproliferative DR
 Cotton wool spots
 Intraretinal microvascular abnormalities
 Venous changes
 Arterial changes
 Dark blot Haemorrhages
 Management

20. Preproliferative DR

21. PROLIFERATIVE DR
 NVD
 NVE
 PRERETINAL HAEMORRAGE
 VITREOUS HAEMORRAGE

22. Proliferative DR

23. Argon Laser Photocoagulation

24. DIABETIC MACULOPATHY
 Focal Exudative
 Diffuse Exudative
 Ischemic
 Mixed

25. ADVANCED DR
 Vitreous haemorrage
 Tractional R/D
 Opaque membranes
 Rubiosis irides

26. Advanced DR