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Diabetes: Ophthalmographic Study

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Diabetes is a common cause of blindness, with diabetic retinopathy accounting for 24,000 new cases on blindness annually. It is therefore likely that our patient, Mrs. Lopez, is experiencing vision problems because she has diabetes. One of the first tests conducted by the ophthalmologist in response to her vision problems was a fundoscopic (ophthalmologic) examination, so one of our learning issues is learning more about this test, learn how to interpret the images that we received, and understand how these issues may be caused by diabetes. The American Diabetes Association (AMA) and American Academy of Ophthalmology recommend patients with diabetes receive a fundoscopic examination. This is a common test done by ophthalmologists that uses …show more content…

Lopez, called fluorescein angiography, which is a method by which ophthalmologists can view the vasculature of the eye. In this technique, a fluorophore is injected into the blood vesicles of the eye, illuminating the vasculature. The benefits of this procedure are that through the images, ophthalmologists can easily vessels, blood flow, and where there may be obstructions or leakage in those vessels. While this is often the standard used for looking at blood flow in the eye, more recently there have been concerns that not all capillaries can be visualized by fluorescein angiography. While this test was done on Mrs. Lopez, I do not believe the pictures provided are images from a fluorescein angiography test as the fluorophore would appear as white against a dark background (see image …show more content…

Diabetic retinopathy is caused by blocked blood flow to the eye, causing ischemia or increased permeability of the blood vessels in the eye. Macular edema is caused by swelling in the eye due to the increased permeability, and both of these are common causes of vision loss of those with diabetes. Some factors that can be seen in the retina from a fundoscopic exam that can cause these issues (all of which were detected in our patient), are micro-aneurysms, intrarenal hemorrhages, and hard exudates. All three of these can disrupt the blood-retinal barrier, causing issues with blood flow and swelling. Additionally, lipids and proteins both play important roles in the eye, and if there is improper breakdown of these molecules, they can make deposits in the outer layer eye. The more deposits (hard exudates) a patient has, the larger affect it can have on their vision.

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