Diabetic Retinopathy: Pathogenesis and clinical findings



Mild Non-proliferative DR

 • Outpouchings of the weakened capillary walls or endothelial buds attempting to re-vascularize the ischemic retina -> Micro-aneurysms

Moderate Non-proliferative DR

 • Weakened BRB allows for rupture into the deeper retinal layers -> Dot/blot Hemorrhages

 • Yellow lipid deposits with sharp margins due to lipoproteins and other proteins leaking through the damaged BRB -> Hard Exudates

 • Nerve fiber layer infarcts from occlusions of the precapillary arterioles -> Cotton-wool spots

Severe Non-proliferative DR

 • Retinal hemorrhages occurring in the more superficial nerve layer -> Flame Hemorrhages

 • Focal areas of saccular venous bulges due to significant retinal ischemia -> Venous beading

Proliferative DR

 • Localized retinal ischemia causes upregulation of VEGF causing fine, irregular, and easilyfriable neovascularization in the disc, macula, and/or retina -> Neovascularization



#Diabetic #Retinopathy #Diabetes #ophthalmology #diagnosis #complications #pathophysiology