Presentation on theme: "Welcome to CNIB’s InFocus Webinar Series"— Presentation transcript:
1 Welcome to CNIB’s InFocus Webinar Series Webinar 1: Diabetic Retinopathy BasicsNetan Choudhry M.D. FRCS(C)25 October 2012
2 Diabetic Retinopathy Basics: Objectives Participants will learn about:Anatomy of the eyeDiabetic retinopathy definedSigns and symptomsTypes of diabetic retinopathyRisk factors and preventionDiagnostic testsTreatment
3 Anatomy of the EyeThe retina – senses light & transmits images to the brainThe macula – central part of the retina used to read and see fine details clearlyThe vitreous – clear gel fills the back of the eye and sits in front of the retinaFigure 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 VisionFigure 4: How vision may be affected by diabetic retinopathyFloatersBlurred visionBlank or dark areas in field of visionPoor night visionVision 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 edemaFigure 6: Fluorescein angiogramof macular edemaFluorescein 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 detachmentTractional retinal detachment Scar tissue can shrink causing the retina todetach and result in vision loss. More severevision 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 sugarDiabetes typeSmokingEthinicityHigh blood pressureHigh cholesterolObesityEarly detection via eye exams is paramountType 1 diabetes: within 5 years of diagnosis, then annuallyType 2 diabetes: at time of diagnosis, then annuallyGestational diabetes: within 1st trimester
10 Treatments Proliferative retinopathy Laser surgery Figure 10: Laser photocoagulationMicroscopic thermal laser burnsare made in the retinaShrinks and prevents abnormal newblood vessel growth, and stops leaking of blood vesselsCan reduce risk of further vision loss by 50%Also recommended to treat macular edema
11 Treatments Proliferative retinopathy Intraocular (anti-VEGF) injectionsFigure 11: Intraocular injectionReduces swelling in the retina and causes abnormal vessels to regress
12 Treatments Diabetic macular edema Lucentis Health-Canada-approved anti-VEGF treatmentApproved for reimbursement in Quebec only
13 Treatments Advanced proliferative retinopathy Vitrectomy Cloudy vitreous is removed and replaced with a clear solutionthat mimics the normal eye fluidsAllows light rays to focus on the retina againFigure 12: Pars plana vitrectomy
14 Eye Connect: Diabetic Retinopathy cnib.ca/dr- Diabetic retinopathy basics - Prevention - Diagnosis and treatment - Living with diabetic retinopathy - Health care professionals’ page - Patient guide
15 CNIB Contacts and Resources CNIB website: cnib.caToll-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.
17 CNIB In Focus Webinar Series Webinar 2: Diabetes Management with Vision Loss When: 13th 1:00pm ESTWebinar 3: Supporting Your Patients with Vision Loss: Practical Tips and Strategies When: 15th 1:00pm ESTWebinar 4: Adjusting to Vision Loss When: 21st 1:00pm ESTcnib.ca/dr