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Welcome to CNIB’s InFocus Webinar Series Webinar 1: Diabetic Retinopathy Basics Presented by: Netan Choudhry M.D. FRCS(C)
Date: 25th October 2012 Start Time: 1:00 pm EST
CNIB In Focus Webinar 1: Diabetic Retinopathy Basics
Slide 2: Diabetic Retinopathy Basics: Objectives
Participants will be able to learn about:
Anatomy of the eye What is Diabetic Retinopathy Signs and Symptoms Types of Diabetic Retinopathy Risk Factors and Prevention Diagnostic Tests Treatment Frequently Asked Questions
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CNIB In Focus Webinar 1: Diabetic Retinopathy Basics
Slide 3: The Anatomy of the EyeThe Retina – senses light and 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
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CNIB In Focus Webinar 1: Diabetic Retinopathy Basics
Slide 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 macular edema (swelling of the retina)
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CNIB In Focus Webinar 1: Diabetic Retinopathy Basics
Slide 5: Signs and Symptoms
Floaters Blurred vision Fluctuating vision Blank or dark areas in field of vision Poor night vision
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Figure 3: Normal Vision
Figure 4: How vision may be affected by diabetic retinopathy
CNIB In Focus Webinar 1: Diabetic Retinopathy Basics
Vision loss
Slide 6: Types of Diabetic RetinopathyEarly 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 6: Fluorescein angiogram of macula edema Figure 5: Macula edema
Fluorescein dye leaking in macula
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CNIB In Focus Webinar 1: Diabetic Retinopathy Basics
Slide 7: Types of Diabetic RetinopathyLate stages:Proliferative diabetic retinopathy (PDR) Retinal vessels close causing significant reduction in blood flow. The retina responds by growing new abnormal vessels. Can affect both central and peripheral vision. Vitreous hemorrhageNew blood vessels bleed into vitreous cavity.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.
Figure 5: Macula edema Figure 6: Fluorescein angiogram of macular edema
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CNIB In Focus Webinar 1: Diabetic Retinopathy Basics
Slide 8: Risk Factors/Prevention
Uncontrollable Diabetes type Ethnicity
Controllable High blood sugar Smoking High blood pressure High cholesterol Obesity
Early detection via eye exams is paramount
Figure 7: Tractional retinal detachment
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Figure 8: Fluorescein angiogram
Figure 9: Optical coherencetomography (OCT)
CNIB In Focus Webinar 1: Diabetic Retinopathy Basics
Type 1 diabetes: within 5 years of diagnosis, then annually
Type 2 diabetes: at time of diagnosis, then annuallyGestational diabetes: within 1st trimesterSlide 9: Diagnostic Tests
Basic assessment Visual acuity test Tonometry: Measures pressure inside the eye
Dilated eye examAdvanced assessment
Fluorescin angiogram: dye is injected systemically which demonstrates retinal circulation
Optical coherence tomography (OCT): non-invasive imaging study that reveals retinal anatomy
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Figure 10: Laser photocoagulation
CNIB In Focus Webinar 1: Diabetic Retinopathy Basics
Slide 10: Treatments
Proliferative retinopathy
Laser surgery• 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
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CNIB In Focus Webinar 1: Diabetic Retinopathy Basics
Slide 11:TreatmentsProliferative retinopathy
Intraocular (anti-VEGF) injections• Reduces swelling in the retina and causes abnormal
vessels to regress
Figure 11: Intraocular injection
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CNIB In Focus Webinar 1: Diabetic Retinopathy Basics
Slide 12: Treatments
Diabetic macular edema
Lucentis
• Health-Canada-approved anti-VEGF treatment• Approved for reimbursement in Quebec only
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CNIB In Focus Webinar 1: Diabetic Retinopathy Basics
Slide 13: TreatmentsAdvanced 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
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CNIB In Focus Webinar 1: Diabetic Retinopathy Basics
Slide 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
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CNIB In Focus Webinar 1: Diabetic Retinopathy Basics
Final - Slide 15: CNIB Contacts and Resources
• CNIB website: cnib.ca• Toll-free
CNIB Helpline: 1-800-563-2642
• Email: [email protected]
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.
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CNIB In Focus Webinar 1: Diabetic Retinopathy Basics
Web: cnib.caEmail: [email protected] Helpline: 1-800-563-2642
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