Handbook of Retinal Screening in Diabetes Diagnosis and Management

by Taylor, Roy; Batey, Deborah

• ISBN13: 9780470658499
• ISBN10: 0470658495
• Edition: 2nd
• Format: Paperback
• Copyright: 2012-04-23
• Publisher: Wiley-Blackwell

Summary

Beginning with chapters summarizing the basics of diabetic retinopathy, this updated volume outlines the need for screening, how to screen safely and correctly, and the normal condition of the retina without diabetic retinopathy, all using excellent line and halftone illustrations. The core focus then moves on to examining each different form of retinopathy, all supported by outstanding colorr retinal photographs illustrating the appearance of the retina at various stages of retinopathy, plus an analysis on the best treatment for each stage. The book ends with chapters providing self-assessment questions of the type that screeners will encounter when gaining their now mandatory retinal screening qualifications, as well as a background information chapter offering advice on related UK, European, and US organizations. A website contains all the full-color retinopathy images from the book, with the option to download these into presentations.

Author Biography

Roy Taylor, University of Newcastle upon Tyne and Newcastle Diabetes Centre, UK Deborah Batey, University of Newcastle upon Tyne and Newcastle Diabetes Centre, UK

Table of Contents

Preface	p. ix
How to use this book	p. x
Type 1 Diabetes	p. 1
What causes type 1 diabetes?	p. 1
Who gets type 1 diabetes?	p. 1
How does it present?	p. 1
Essentials of management	p. 2
Complications	p. 7
History	p. 8
Further reading	p. 9
Type 2 Diabetes	p. 10
What causes type 2 diabetes?	p. 10
Who gets type 2 diabetes?	p. 10
How does it present?	p. 11
Management	p. 11
Complications	p. 14
History	p. 15
Further reading	p. 17
The Eye in Diabetes	p. 18
Structure of the normal eye	p. 18
The retina	p. 21
Diabetic retinopathy	p. 22
Treatment of sight-threatening diabetic retinopathy	p. 26
Further reading	p. 28
The Need to Screen	p. 29
Is blindness preventable?	p. 29
Can the progression of retinopathy be slowed?	p. 32
Detecting asymptomatic retinopathy by screening	p. 32
The five principles of retinal screening	p. 35
Quality assurance	p. 36
Retinal screening from the patient's perspective	p. 38
Retinal screening from the screener's perspective	p. 39
History of the development of retinal screening by photography-based systems in the UK	p. 40
Further reading	p. 41
Practical Screening	p. 42
Important first steps	p. 42
Measuring visual acuity	p. 43
Instilling eyedrops	p. 47
Obtaining the image	p. 50
Examining the image	p. 51
Grading the image	p. 54
Explaining the results of screening	p. 57
Success of the screening visit	p. 59
Organization of a district screening system	p. 59
Links with your ophthalmologist	p. 62
Further reading	p. 64
Normal Retinal Appearances	p. 65
Light reflection artefact (Figure 6.1)	p. 66
Light reflection artefact (Figure 6.2)	p. 67
Tortuous vessels (Figure 6.3)	p. 68
Tiger striping (Figure 6.4)	p. 69
Tiger striping (Figure 6.5)	p. 70
Myelinated fibres (Figure 6.6)	p. 71
Myopic crescent (Figure 6.7)	p. 72
Pigmented image (Figure 6.8)	p. 73
Asteroid hyalosis (Figure 6.9)	p. 74
Choroidal circulation (Figure 6.10)	p. 75
Eyelash artefact (Figure 6.11)	p. 76
Background Retinopathy	p. 77
What is background retinopathy?	p. 77
Lesions	p. 77
Early background (Figure 7.1)	p. 78
Early background (Figure 7.2a)	p. 79
Early background (red-free version of Figure 7.2a) (Figure 7.2b)	p. 80
Early background (Figure 7.3)	p. 81
Early background (Figure 7.4)	p. 82
Early background (Figure 7.5)	p. 83
Early background (Figure 7.6)	p. 84
Moderate background (Figure 7.7a)	p. 85
Moderate background (red-free version of Figure 7.7a) (Figure 7.7b)	p. 86
Maculopathy	p. 87
What is maculopathy?	p. 87
Management of maculopathy	p. 88
Exudates close to the fovea (Figure 8.1)	p. 90
Severe retinopathy close to the macula (Figure 8.2)	p. 91
Widespread exudates (Figure 8.3)	p. 92
Large plaque exudates (Figure 8.4)	p. 93
Linear exudates close to the fovea (Figure 8.5)	p. 94
Plaque exudates near the fovea (Figure 8.6)	p. 95
Circulate exudates within the arcades (Figure 8.7)	p. 96
Widespread exudates with circulates (Figure 8.8)	p. 97
Coalescent exudates in the macular region (Figure 8.9)	p. 98
Severe Non-proliferative ('Pre-proliferative') Retinopathy	p. 99
Management of severe, non-proliferative retinopathy	p. 99
Severe non-proliferative retinopathy (Figure 9.1)	p. 100
Severe non-proliferative retinopathy (Figure 9.2)	p. 101
Severe non-proliferative retinopathy (Figure 9.3)	p. 102
Severe non-proliferative (Figure 9.4)	p. 103
Proliferative Retinopathy	p. 104
What is proliferative retinopathy?	p. 104
Management of proliferative retinopathy	p. 104
New vessels on the disc (Figure 10.1)	p. 105
Disc new vessels (Figure 10.2)	p. 106
Retinal new vessels (Figure 10.3a)	p. 107
Retinal new vessels - red-free image of Figure 10.3a (Figure 10.3b)	p. 108
New vessels on the retina (Figure 10.4)	p. 109
New vessels on the retina (Figure 10.5)	p. 110
New vessels on the retina (Figure 10.6)	p. 111
New vessels on the retina (Figure 10.7a)	p. 112
New vessels on the retina - red-free version of Figure 10.7a (Figure 10.7b)	p. 113
Old panretinal laser scars (Figure 10.8)	p. 114
Panretinal laser scars (Figure 10.9)	p. 115
Disc and retinal new vessels, with exudative maculopathy (Figure 10.10a)	p. 116
Disc and retinal new vessels, with exudative maculopathy (red-free version of Figure 10.10a) (Figure 10.10b)	p. 117
Advanced Diabetic Eye Disease	p. 118
What is advanced?	p. 118
Management of advanced diabetic eye disease	p. 118
Early fibrosis (Figure 11.1)	p. 119
Fibrosis (Figure 11.2)	p. 120
Fibrovascular membrane (Figure 11.3)	p. 121
Preretinal haemorrhage (Figure 11.4)	p. 122
Preretinal haemorrhage (Figure 11.5)	p. 123
Severe exudative maculopathy (Figure 11.6)	p. 124
Preretinal haemorrhage and persisting new vessel formation (Figure 11.7)	p. 125
Preretinal haemorrhage (Figure 11.8)	p. 126
Fibrous band and heavy laser scars (Figure 11.9)	p. 127
Non-diabetic Eye Disease	p. 128
What other diseases are common?	p. 128
Other eye diseases	p. 128
Drusen (Figure 12.1)	p. 131
Drusen (Figure 12.2)	p. 132
Atrophic chorioretinital scars (Figure 12.3)	p. 133
Old chorioretinitis (Figure 12.4)	p. 134
Papilloedema (Figure 12.5)	p. 135
One year later - same eye as shown in Figure 12.5 (Figure 12.6)	p. 136
Papilloedema (Figure 12.7)	p. 137
Pigment epithelial hypertrophy (Figure 12.8)	p. 138
Cholesterol embolus (Figure 12.9)	p. 139
Branch retinal vein occlusion (Figure 12.10)	p. 140
Central retinal vein occlusion (Figure 12.11)	p. 141
Branch retinal artery occlusion (Figure 12.12)	p. 142
Glaucomatous disc (Figure 12.13)	p. 143
Macular hole (Figure 12.14)	p. 144
Background Information	p. 145
The UK Retinal Screening Diploma	p. 145
Working towards the full Diploma	p. 146
Driving and diabetes	p. 146
Pregnancy	p. 147
Insurance and diabetes	p. 147
Employment and diabetes	p. 147
Prescription charges	p. 148
British Association of Retinal Screening	p. 148
Diabetes UK	p. 148
National Retinopathy Screening Systems	p. 149
Patient leaflets	p. 149
Ophthalmoscopy	p. 150
Self-assessment Questions	p. 152
	p. 152
	p. 153
	p. 154
	p. 154
	p. 155
	p. 157
Answers to Self-assessment Questions	p. 158
	p. 158
	p. 159
	p. 160
	p. 160
Chapter 5	p. 161
Glossary of terms	p. 163
Index	p. 167
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