Handbook of Retinal Screening in Diabetes : Diagnosis and Management

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  • Edition: 2nd
  • Format: Paperback
  • Copyright: 2012-04-23
  • Publisher: Wiley-Blackwell
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Supplemental Materials

What is included with this book?

  • The New copy of this book will include any supplemental materials advertised. Please check the title of the book to determine if it should include any access cards, study guides, lab manuals, CDs, etc.


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

Prefacep. ix
How to use this bookp. x
Type 1 Diabetesp. 1
What causes type 1 diabetes?p. 1
Who gets type 1 diabetes?p. 1
How does it present?p. 1
Essentials of managementp. 2
Complicationsp. 7
Historyp. 8
Further readingp. 9
Type 2 Diabetesp. 10
What causes type 2 diabetes?p. 10
Who gets type 2 diabetes?p. 10
How does it present?p. 11
Managementp. 11
Complicationsp. 14
Historyp. 15
Further readingp. 17
The Eye in Diabetesp. 18
Structure of the normal eyep. 18
The retinap. 21
Diabetic retinopathyp. 22
Treatment of sight-threatening diabetic retinopathyp. 26
Further readingp. 28
The Need to Screenp. 29
Is blindness preventable?p. 29
Can the progression of retinopathy be slowed?p. 32
Detecting asymptomatic retinopathy by screeningp. 32
The five principles of retinal screeningp. 35
Quality assurancep. 36
Retinal screening from the patient's perspectivep. 38
Retinal screening from the screener's perspectivep. 39
History of the development of retinal screening by photography-based systems in the UKp. 40
Further readingp. 41
Practical Screeningp. 42
Important first stepsp. 42
Measuring visual acuityp. 43
Instilling eyedropsp. 47
Obtaining the imagep. 50
Examining the imagep. 51
Grading the imagep. 54
Explaining the results of screeningp. 57
Success of the screening visitp. 59
Organization of a district screening systemp. 59
Links with your ophthalmologistp. 62
Further readingp. 64
Normal Retinal Appearancesp. 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 Retinopathyp. 77
What is background retinopathy?p. 77
Lesionsp. 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
Maculopathyp. 87
What is maculopathy?p. 87
Management of maculopathyp. 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') Retinopathyp. 99
Management of severe, non-proliferative retinopathyp. 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 Retinopathyp. 104
What is proliferative retinopathy?p. 104
Management of proliferative retinopathyp. 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 Diseasep. 118
What is advanced?p. 118
Management of advanced diabetic eye diseasep. 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 Diseasep. 128
What other diseases are common?p. 128
Other eye diseasesp. 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 Informationp. 145
The UK Retinal Screening Diplomap. 145
Working towards the full Diplomap. 146
Driving and diabetesp. 146
Pregnancyp. 147
Insurance and diabetesp. 147
Employment and diabetesp. 147
Prescription chargesp. 148
British Association of Retinal Screeningp. 148
Diabetes UKp. 148
National Retinopathy Screening Systemsp. 149
Patient leafletsp. 149
Ophthalmoscopyp. 150
Self-assessment Questionsp. 152
p. 152
p. 153
p. 154
p. 154
p. 155
p. 157
Answers to Self-assessment Questionsp. 158
p. 158
p. 159
p. 160
p. 160
Chapter 5p. 161
Glossary of termsp. 163
Indexp. 167
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