Diabetic_Retinopathy_Detailed_Presentation.pptx

Diabetic retinopathy

1. Diabetic Retinopathy: A Detailed Overview Pathogenesis, Diagnosis, and Management Name/Class/Date

2. Introduction Definition: Diabetic retinopathy (DR) is a microvascular complication of diabetes affecting retinal blood vessels. Significance: Leading cause of vision loss among adults with diabetes.

3. Pathogenesis – Molecular Level - Hyperglycemia activates: - Polyol pathway → Sorbitol accumulation - AGEs → Basement membrane thickening, inflammation - PKC pathway → ↑VEGF, vasoconstriction - Hexosamine pathway → Gene expression changes

4. Microvascular Changes - Pericyte loss - Endothelial cell damage - Capillary occlusion & leakage - Basement membrane thickening - ↑ VEGF → Neovascularization

5. Histopathology - Microaneurysms - Capillary nonperfusion - Cotton-wool spots - Hard exudates - IRMA - Neovascularization

6. ETDRS Classification - NPDR: - Mild: Microaneurysms - Moderate: Hemorrhages in 1 quadrant - Severe: 4-2-1 Rule - PDR: - Early: NVE - High-risk: NVD >1/3 disc, hemorrhages

7. Diabetic Macular Edema (DME) - OCT-based: - Center-Involved DME (CI-DME) - Non-Center-Involved - ETDRS CSME: - Thickening ≤500 µm from fovea - Exudates with thickening

8. Diagnostic Tools - OCT - FFA - OCT-A - B-scan USG - Fundus autofluorescence

9. Treatment – Anti-VEGF - Ranibizumab, Aflibercept, Bevacizumab - Monthly loading dose x 3-6 - Maintenance: PRN or treat-and-extend

10. Steroids & Laser Therapy - Steroids: - Dexamethasone implant (3–6 months) - Fluocinolone (up to 36 months) - Laser: - Focal/Grid for DME - PRP for PDR (1200–1600 burns)

11. Vitrectomy & Systemic Care - Indications: Vitreous hemorrhage, TRD, pre-macular hemorrhage - Systemic Targets: - HbA1c < 7% - BP < 140/90 - LDL < 100 mg/dL - Smoking cessation

12. Prognosis & Follow-Up - Prognosis: - Good with early treatment - PDR: 25% risk of blindness → <5% with treatment - Follow-Up: - No DR: 1–2 yrs - Mild NPDR: 6–12 months - PDR: Every 1–3 months

13. Summary - DR is preventable & treatable - Early detection via screening is key - Anti-VEGF & laser therapy are mainstays - Systemic control vital for prevention

14. Thank You Questions? Contact info (if needed)