By S. Riaskoff (auth.)
The assessment of diabetic retinopathy is frequently tough, as the medical photo is complicated as a result mUltiplicity of signs. Omission of remedy by way of photocoagulation on the correct second could have grave results. Forthe assessment of diabetic retinopathy we need to estimate first the developmental measure of every symptom and secondly we need to estimate what the traditional historical past of every specific retinopathy might be. There exists a couple of type structures, into the body of which the medical photo of diabetic retinopathy could be positioned. with no getting into the main points of those structures we wish to point out that our class has been constructed from the tactic of Oakley and the category version conceived on the Airlie apartment assembly in 1968. The essence of this category is that ordinary photos are used for the estimation of the developmental measure of the several indicators in diabetic retinopathy. In our type we use for every symptom average pictures rather than one, as initially proposed on the Airlie residence assembly. (1,2). usual photo #1 stands for the average (grade 1 ) manifestation and conventional photo numbertwo stands forthe marked (grade 2) manifestation of the symptom. Ifthe manifestation ofthe sympton is much less marked than in ordinary picture one, it's often called < 1 ; whether it is extra marked than in average picture , it really is known as > 2.
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The assessment of diabetic retinopathy is usually tricky, as the medical photo is advanced a result of mUltiplicity of signs. Omission of therapy via photocoagulation on the correct second could have grave outcomes. Forthe overview of diabetic retinopathy we need to estimate first the developmental measure of every symptom and secondly we need to estimate what the average background of every specific retinopathy could be.
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Extra info for Diabetic Retinopathy
Photocoagulation: treatment is useless. Comment: the eye became completely blind due to a massive vitreous haemorrhage, shortly after this photograph was taken. 44 8 Preretinal haemorrhages (H) Fig. 29a: H, Man, 34 years old, diabetes for 14 years. Left eye: A moderate (grade 1 ) preretinal haemQrrhage should be diagnosed when a haemorrhage is located on the surface Qfthe retina under the internal limiting membrane, or between this membrane and the posterior vitreous membrane. The same gradation is used when the haemorrhage is small and does not diffuse into the vitreous body, or is only partly diffusing so that the fundus can still be examined.
The main targets for photocoagulation in non-proliferative diabetic retinopathy are therefore intraretinal haemorrhages and grouped microaneurysms (see figures 33 and 34). The coagulation of hard exudates and cotton-wool spots is useless. On the border of old cotton-wool patches, however, very often a dilatation and proliferation of capillaries is observed. From this point of view it is advisable to coagulate around cotton-wool spots in order to prevent future neovascularization (see arrows in figures 33 and 34).
The periphery presented only some intraretinal haemorrhages and a narrowing of the small arteriolar branches. 0. Fig. 21 a: Npap2 The same patient. Right eye: When newly-formed vessels extend for a greater distance from the border of the disc and their calibre becomes larger we speak about marked (grade 2) neovascularization on the disc. Frequently at the same time vitreous retraction sets in causing the first small haemorrhages (arrows). Stage II, advanced diabetic retinopathy when moderate neovascularization on the disc is present.