From the Guidelines
Proliferative diabetic retinopathy (PDR) is characterized by the presence of new vessels on the disc or elsewhere in the retina, which can lead to vitreous hemorrhage, retinal detachment, and vision loss. The funduscopy findings in a 40-year-old male with diabetes diagnosed with PDR may include:
- New vessels on the disc (NVD) or elsewhere in the retina (NVE) 1
- Venous beading, which is a sign of severe nonproliferative diabetic retinopathy (NPDR) that can progress to PDR 1
- Preretinal hemorrhage, which can occur when new vessels bleed into the vitreous gel 1
- Retinal thickening, hard exudates, and cotton wool spots, which are signs of diabetic macular edema (DME) that can occur in conjunction with PDR 1
- Neovascularization, which is the growth of new blood vessels on the retina or iris, and can lead to complications such as vitreous hemorrhage and retinal detachment 1 The International Classification of Diabetic Retinopathy and Diabetic Macular Edema, as outlined in Table 1 of the guidelines 1, provides a framework for classifying the severity of diabetic retinopathy based on clinical findings, including the presence of new vessels, hemorrhages, and retinal thickening. The Early Treatment Diabetic Retinopathy Study (ETDRS) classification, as referenced in 1, also provides a standardized system for grading diabetic retinopathy from stereoscopic color fundus photographs.
From the Research
Funduscopy Findings in Proliferative Diabetic Retinopathy
The funduscopy findings in a 40-year-old male with diabetes diagnosed with proliferative diabetic retinopathy may include:
- Retinal neovascularization, which can be detected through fluorescein angiography 2
- Intraretinal microvascular abnormalities (IRMA) and intraretinal hemorrhages, which can be observed through fundus fluorescein angiography (FFA) 3
- Fibrous proliferation, which can be detected through ophthalmoscopy or fundus photography 4
Detection Methods
Different methods can be used to detect proliferative diabetic retinopathy, including:
- Fundus photography, which can be used to detect diabetic retinopathy with high sensitivity and specificity 5
- Ophthalmoscopy, which can be used to detect retinopathy with high agreement with fundus photography 4
- Fundus fluorescein angiography (FFA), which can be used to detect retinal angiopathy with higher detection accuracy than fundus photography 3
- Seven field stereo fundus photographs, which can be used to identify retinal neovascular lesions 2
Limitations of Detection Methods
However, some detection methods may have limitations, such as: