![]() However, if your blood sugars are too high for too long, you may notice some of the signs of diabetes in the eye. Your primary care doctor will likely instruct you to see your eye doctor as part of your overall diabetes care. In the early stages, you may not know you have diabetes. How will I know if I have diabetes in my eye? If you have diabetes, it is extremely important to get routine follow up with your eye doctor to detect these changes at an early stage. If these changes are detected early, they are much more treatable than if they are advanced at the time of diagnosis. These affects can be profound, leading to vision loss. ![]() They tend to leak fluid, form scar tissue and can pull on the retina, causing retinal detachments. However, these vessels are not normal vessels. Eventually, the oxygen-deprived retina releases a chemical (VEGF) that causes more blood vessels to grow. Jan 2017.These damaged vessels are unable to adequately transport oxygen to retina, which can damage the nerve tissue – a process called retinal ischemia. Updated 2017 ICO guidelines for diabetic eye care. Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales. Helps in differentiating different types of DRġ Modified from: Wilkinson CP, Ferris FL III, Klen RE, et al.Retinal thickening zone or zones of ≥1 disc area in size, any part of which is within 1 disc diameter of the center of the macula.Hard exudates at or within 500 microns of the center of the macula, if associated with thickening of the adjacent retina.Retinal thickening at or within 500 microns of the center of the macula (approximately ½ optic disc diameter).May occur at any stage of DR and defined to include any 1 of the following features:.Severe or central-involved DME if the retinal thickening or hard exudates involves the center of the macula that is 1 mm in diameterĬlinically Significant Macular Edema (CSME).Moderate or noncentral-involved DME if the retinal thickening or hard exudates approaches the center of the macula but does not involve the center that is 1 mm in diameter.Mild DME if the retinal thickening or hard exudates in the posterior pole is distant from the center of the macula.No macular edema if there is no retinal thickening or hard exudates in the posterior pole.Severity of DME can help determine the appropriate treatment modality to give the patient and follow-up recommendationsĭME Severity Scale based on Observation upon Dilated Ophthalmoscopy 1.Classified into noncenter-involved or center-involved macular edema.Recommended to be evaluated through dilated examination using slit-lamp biomicroscopy, OCT, and/or stereoscopic fundus photography.Occurs at any stage of DR and can run an independent course.Thickening located within 2 disc diameters of the center of the macula.Vitreous and/or preretinal hemorrhage associated with less extensive NVD or with NVE ≥½ disc area in size.Have neovascularization within 1 disc diameter of the optic nerve head that are ≥¼-⅓ disc area with or without vitreous or preretinal hemorrhage or.Presents with neovascularization and/or vitreous/preretinal hemorrhage but does not meet the criteria for high-risk PDR.Definite venous beading in ≥2 quadrants.≥20 intraretinal hemorrhages in each of 4 quadrants.Severe NPDR have any of the following but with no signs of proliferative retinopathy:.Presence of microaneurysms and other signs (eg hard exudates, cotton wool spots, dot and blot hemorrhages) but less than severe NPDR.May develop from existing severe NPDR or without substantial NPDRĭiabetic Retinopathy Disease Severity Level based on Findings upon Dilated Ophthalmoscopy 1.Neovascularization (NVD and NVE) causes preretinal and vitreous hemorrhage, subsequent fibrosis and traction retinal detachment.Onset of neovascularization of the inner surface of the retina that is induced by retinal ischemia.Venous abnormalities (eg beading, dilation, loops).As the disease progresses, gradual closure of the retinal vessels occur that eventually results to impaired perfusion and retinal ischemia manifested as:.Visual loss is primarily caused by macular edema.Nerve-fiber layer infarcts (cotton-wool spots).Microvascular abnormalities (eg microaneurysms, occluded vessels and dilated/tortuous vessels).Characterized by abnormalities primarily in the posterior retina and macula consisting of:.Earliest clinically apparent stage of DR.
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