Hello and welcome to the zero to finals podcast.

My name is Tom and in this episode I'm going to be talking to you about diabetic retinopathy.

And you can find written notes on this topic at zero to finals.com slash diabetic retinopathy

or in the ophthalmology section of the second edition of the

zero to finals medicine book and you can find flashcards and questions to train your knowledge on

this content and help you remember the information for longer at members.0.0.com. So let's get straight into it.

Diabetic retinopathy involves damage to the retinal blood vessels due to prolonged

high blood sugar levels in diabetes. Let's start with the pathophysiology.

Hyperglycemia, which is a high blood glucose level,

damages the small vessels in the retina at the back of the eye,

particularly the endothelial cells of these blood vessels.

Increased vascular permeability leads to leaking blood vessels, blot hemorrhages and hard exudates on the retina.

Hard exudates are yellow-white deposits of lipids and proteins on the retina.

Damage to the blood vessel walls leads to micro aneurysms and venous beading.

Micro aneurysms are small bulges in the blood vessel walls.

Venus beading is where the walls of the veins of the retina are no longer straight and parallel,

and they look more like a string of beads or a string of sausages.

Damage to nerve fibres in the retina causes fluffy white patches called cotton wool spots.

Intraternal microvascular abnormnormalities, or IMRA, refers to dilated and tortuous

capillaries on the retina. These connect as a shunt between the arterial and the venous

vessels in the retina, meaning that blood flows directly from the arterial to the venous vessels.

Neovascularization involves the release of growth factors which stimulates new blood vessel

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