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Diabetic Retinopathy
Bruno Lumbroso, Marco Rispoli, Maria Cristina Savastano
CHAPTER 1:
Diabetes
CLASSIFICATION OF DIABETES MELLITUS
CHAPTER 2:
Diabetic Retinopathy
INCIDENCE AND PREVALENCE
PREVALENCE
EPIDEMIOLOGY
PROGNOSIS
TREATMENT
CHAPTER 3:
Classification
CHAPTER 4:
Pathogenesis of Diabetic Retinopathy
EXUDATION
LESIONS IN VESSEL WALLS (FLOW CHART 1)
CHANGES IN BLOOD FLOW (FLOW CHART 4)
ISCHEMIA
ALTERATIONS IN THE PLATELETS
ALTERATIONS IN THE ARTERIOLES
VEGF-PROLIFERATION OF NEW VESSELS
GENETIC FACTORS
CHAPTER 5:
Pathophysiology of Diabetic Retinopathy
CHAPTER 6:
Diabetic Retinopathy Natural Evolution
INCIPIENT RETINOPATHY: ELEMENTARY LESIONS (TABLE 1)
Alterations in the Macular Capillary Network
Macular Capillary Network More Evident Than Normal
Microaneurysms
Background Microaneurysms
Advanced Microaneurysms
Thrombosed Microaneurysms
Areas of Ischemia
Interrupted Arteriolar Branches
Hard Exudates in the Deep Layers
Cotton Wool Exudates (Nodules)
NON-PROLIFERATIVE EXUDATIVE RETINOPATHY
Venous Alterations
Venous Dilations
Arterovenous Shunts
Duplications
Venous Meanders and Loops
Intraretinal Microvascular Abnormalities
Dilated Capillaries, Microaneurysms, Marked Leakage
Rings of Hard Circinnate or Star-shaped Exudates
Focal and Diffuse Macular Edema
Focal and Diffuse Tractional Macular Edema
Cystoid Macular Edema (Table 3)
A “Petalloid” or “Honeycomb” Aspect
ADVANCED RETINOPATHY
Capillary Abnormalities
Ischemic Areas
Fluoroangiographic Study of The Retinal Periphery
How New Vessels Form
PROLIFERATIVE RETINOPATHY
New Vessels
Progression of Proliferative Retinopathy
Tractional Detachments
Vitreal Hemorrhages
Antiangiogenic Treatment and Adequate Photocoagulation
Retinal Detachment
Vitrectomy
Neovascular Glaucoma
Iris Rubeosis, Blindness
DIABETIC MACULOPATHY
ISCHEMIC MACULOPATHY
CHAPTER 7:
Retinal Fluoroangiography
INTRODUCTION
INTERPRETATION OF THE FLUOROANGIOGRAPHY IN DIABETIC RETINOPATHY
Analysis
Synthesis Study
ANALYSIS OF FLUOROANGIOGRAPHY: ELEMENTARY ABNORMALITIES
Morphological Alterations
Alteration in the Perimacular Vascular Network
Lesions of the Capillaries
Venous Alterations
Dynamic Changes
Slowdown in Blood Flow
HYPERFLUORESCENCE: DUE TO LEAKAGE
Leakage
Intraretinal Microvascular Abnormalities
New Vessels
HYPERFLUORESCENCE: STAINING
Staining
Focal Edema
Diffuse Edema
Vascular Walls
HYPERFLUORESCENCE: POOLING
Pooling
Fluorescein Pooling
Microaneurysms
Cystoid Edema
HYPOFLUORESCENCE
Masked (Screened) Hypofluorescence
Total Screen
Hemorrhages
Imperfect or Transient Screen
Hard Exudates
HYPOFLUORESCENCE DUE TO VASCULAR FILLING DEFECTS
Capillary Occlusions
Areas of Nonperfusion
IMAGING OVERVIEW OF FLUOROANGIOGRAPHY IN DIABETIC RETINOPATHY
Nonproliferative Diabetic Retinopathy
Analytic Study
Synthesis Study
Severe (Preproliferative) Diabetic Retinopathy
Analytic Study
Synthesis Study
Proliferative Diabetic Retinopathy
Analytic study
Synthesis study
CHAPTER 8:
OCT in Diabetic Retinopathy
INTRODUCTION
OCT IN NONPROLIFERATIVE DIABETIC RETINOPATHY
ELEMENTARY LESIONS
Cotton-Wool Exudates
Hard Exudates
Hemorrhages
Macular Edema
Diffuse Edema
Cystoid Macular Edema
OCT ‘En Face’ Aspects (Fig. 5B; Figs 6C and D)
Serous Detachment of the Fovea
Traction Edema
Quantification
Retinal Topography
Retinal Thickness
PROGRESSION OF NONPROLIFERATIVE DIABETIC RETINOPATHY
OCT IN PROLIFERATIVE RETINOPATHY
Preretinal New Vessels
Prepapillary New Vessels
TRACTION RETINAL DETACHMENT
CHAPTER 9:
OCT Angiography
INTRODUCTION
INCIPIENT DIABETIC RETINOPATHY
BACKGROUND DIABETIC RETINOPATHY
ADVANCED RETINOPATHY AND RETINAL ISCHEMIA
PROLIFERATIVE DIABETIC RETINOPATHY
CHAPTER 10:
Diabetic Retinopathy Treatment
PREVENTION
MEDICAL TREATMENT OF DIABETIC RETINOPATHY
LASER TREATMENT
Classical Laser
Multispot Laser
Differences between Classical Lasers and Multispot Lasers for the Operator and the Patient
INDICATIONS FOR LASER TREATMENT AND TECHNIQUES FOR TREATING DIABETIC RETINOPATHY
Treatment of Retinal Ischemia and Proliferative Diabetic Retinopathy
Treatment of Posterior Pole Edema in Diabetic Retinopathy
COMPLICATIONS DUE TO LASER TREATMENT
SURGICAL TREATMENT
ANTIANGIOGENIC TREATMENT
Antiangiogenic Treatment in Intravitreal Injections
Intraocular Implants
VITRECTOMY
INDEX
TOC
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