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Diabetic retinopathy (DR) is essentially, but not exclusively, a microvascular disease. Diabetic retinopathy progresses from mild nonproliferative abnormalities, characterized by increased vascular permeability, to moderate and severe nonproliferative diabetic retinopathy (NPDR), characterized by vascular closure, to proliferative diabetic retinopathy (PDR), characterized by the growth of new blood vessels on the retina and posterior surface of the vitreous.PDR neovascularisation2Macular edema, characterized by retinal thickening from leaky blood vessels, can develop at all stages of retinopathy.Faktor risikoDiabetic retinopathy (DR) is commoner in type] (40%) than in type 2 (20%). and is the most prevalent cause of legal blindness between the ages of 20 and 65 years.

Obj.Diabetic retinopathy (DR) may be defined as the presence of typical retinal microvascular lesions in an individual with diabetes.Microaneurysms (Ma), haemorrhages, hard exudates (HEx), cotton wool spots (CWS), intraretinal microvascular abnormalities (IRMA),venous beading (VB), new vessels and fibrous tissue comprise the clinical features of DR.?Macular drusen are bilateral. focal yellow spots which may be mistaken for hard exudates. However, they are not arranged in clumps or rings and arc not associated with retinal microvascular changes.DD dari retinopati diabetik

Blindness

Pocket of Atlas OpthalmologyDiabetic retinopathy is classified according to the presence or absence of abnormal new vessels as: Non-proliferative (background/preproliferative) retinopathy Proliferative retinopathy

Each has a different prognosis for vision.

AK. Khurana, Comprehensive Opthalmology 4th ed.

T. Schlote, et al., Pocket of Atlas Opthalmology, 2006Klasifikasi Retinopati DiabetikIn terms of both prognosis and treatment, it is useful to divide diabetic retinopathy into nonproliferative and proliferative categories. Vaughan & Ashburys Gen. Opthal., 16th ed.

The Royal College of Opthalmologists,Diabetic Retinopathy Guidelines 2012

Guidelines for theManagement of Diabetic Retinopathy, National Health and Medical Research Council (NHMRC) Australian Govt., 2008

The Royal College of Opthalmologists,Diabetic Retinopathy Guidelines 2012NPDRDR is first evident ophthalmoscopically as non-proliferative (previously termed background) retinopathy (NPDR), which may evolve to proliferative retinopathy (PDR). Typical early NPDR lesions include microaneurysms (Ma) and dot, blot or flame haemorrhages (H/Ma).More advanced NPDR lesions include hard exudates (Hex), cotton wool spots (CWS) or soft exudates, intraretinal microvascular abnormalities (IRMA) and venous beading (VB).Guidelines for the Management of Diabetic Retinopathy, National Health and Medical Research Council (NHMRC) Australian Govt., 2008PDRProliferative diabetic retinopathy (PDR) is characterised by growth of abnormal new vessels and fibrous tissue in response to retinal ischaemia, and the subsequent development of pre-retinal or vitreous haemorrhage, or fibrous proliferation. If new vessels appear on or within one disc diameter of the disc margin, they are known as new vessels on the disc (NVD). In other locations, they are referred to as new vessels elsewhere (NVE).High-risk characteristics (HRC) of PDR, signifying a poor visual prognosis, are:(1) NVD disc area in extent, or (2) any NVD with vitreous or pre-retinal haemorrhage, or (3) NVE disc area in extent associated with vitreous or pre-retinal haemorrhage, or (4) vitreous or pre-retinal haemorrhage obscuring 1 disc area.MECapillary leak in the macular or perimacular region results in retinal thickening or diabetic macular edema (oedema)/(DME), defined as thickening located within two disc diameters of the centre of the macula. When this is present within or close to the central macula, it is termed clinically significant macular oedema (CSME)