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Welcome to CNIB’s InFocus Webinar Series

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Presentation on theme: "Welcome to CNIB’s InFocus Webinar Series"— Presentation transcript:

1 Welcome to CNIB’s InFocus Webinar Series
Webinar 1: Diabetic Retinopathy Basics Netan Choudhry M.D. FRCS(C) 25 October 2012

2 Diabetic Retinopathy Basics: Objectives
Participants will learn about: Anatomy of the eye Diabetic retinopathy defined Signs and symptoms Types of diabetic retinopathy Risk factors and prevention Diagnostic tests Treatment

3 Anatomy of the Eye The retina – senses light & transmits images to the brain The macula – central part of the retina used to read and see fine details clearly The vitreous – clear gel fills the back of the eye and sits in front of the retina Figure 1: The human eye

4 What Is Diabetic Retinopathy?
Occurs when elevated blood sugar levels cause blood vessels in the eye to swell and leak into the retina. Figure 2: Diabetic macula edema (swelling of the retina)

5 Signs and Symptoms Floaters Blurred vision
Figure 3: Normal Vision Figure 4: How vision may be affected by diabetic retinopathy Floaters Blurred vision Blank or dark areas in field of vision Poor night vision Vision loss

6 Types of Diabetic Retinopathy
Early stages: Non-proliferative diabetic retinopathy (NPDR) Damaged blood vessels in the retina begin to leak fluid and small amounts of blood and cholesterol. Mild NPDR may not necessarily affect vision. Results of blurred vision: Figure 5: Macula edema Figure 6: Fluorescein angiogram of macular edema Fluorescein dye leaking in macula

7 Types of Diabetic Retinopathy
Late stages: Proliferative diabetic retinopathy (PDR) Retinal vessels close causing significant reduction in blood flow. The retina responds by growing new abnormal vessels. Figure 7: Tractional retinal detachment Tractional retinal detachment Scar tissue can shrink causing the retina to detach and result in vision loss. More severe vision loss occurs if the macula is detached. Can affect both central and peripheral vision. Vitreous hemorrhage New blood vessels bleed into vitreous cavity.

8 Risk Factors/Prevention
High blood sugar Diabetes type Smoking Ethinicity High blood pressure High cholesterol Obesity Early detection via eye exams is paramount Type 1 diabetes: within 5 years of diagnosis, then annually Type 2 diabetes: at time of diagnosis, then annually Gestational diabetes: within 1st trimester

9 Diagnostic Tests Basic assessment Advanced assessment
Fluorescein angiogram: dye is injected systemically which demonstrates retinal circulation Figure 8: Fluorescein angiogram Visual acuity test Tonometry: Measures pressure inside the eye Dilated eye exam Advanced assessment Optical coherence tomography (OCT): non-invasive imaging study that reveals retinal anatomy Figure 9: Optical coherence tomography (OCT)

10 Treatments Proliferative retinopathy Laser surgery
Figure 10: Laser photocoagulation Microscopic thermal laser burns are made in the retina Shrinks and prevents abnormal new blood vessel growth, and stops leaking of blood vessels Can reduce risk of further vision loss by 50% Also recommended to treat macular edema

11 Treatments Proliferative retinopathy
Intraocular (anti-VEGF) injections Figure 11: Intraocular injection Reduces swelling in the retina and causes abnormal vessels to regress

12 Treatments Diabetic macular edema Lucentis
Health-Canada-approved anti-VEGF treatment Approved for reimbursement in Quebec only

13 Treatments Advanced proliferative retinopathy Vitrectomy
Cloudy vitreous is removed and replaced with a clear solution that mimics the normal eye fluids Allows light rays to focus on the retina again Figure 12: Pars plana vitrectomy

14 Eye Connect: Diabetic Retinopathy - Diabetic retinopathy basics - Prevention - Diagnosis and treatment - Living with diabetic retinopathy - Health care professionals’ page - Patient guide

15 CNIB Contacts and Resources
CNIB website: Toll-free CNIB Helpline: Production of this material has been made possible through a financial contribution from the Public Health Agency of Canada. The views expressed herein do not necessarily represent the views of the Public Health Agency of Canada.

16 Q&A Session

17 CNIB In Focus Webinar Series
Webinar 2: Diabetes Management with Vision Loss When: 13th 1:00pm EST Webinar 3: Supporting Your Patients with Vision Loss: Practical Tips and Strategies When: 15th 1:00pm EST Webinar 4: Adjusting to Vision Loss When: 21st 1:00pm EST

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