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 if you want to follow along with written notes on this

topic, you can follow along at zero definals.com slash diabetic retinopathy or in the ophthalmology section of the zero definals medicine book.

So let's jump straight in. Diabetic retinopathy is a condition where the blood vessels in the retina

are damaged by prolonged exposure to high blood sugar levels, which is called hyperglycemia.

This damage to the blood vessels causes a

progressive deterioration in the health of the retina and is caused by diabetes. Let's talk about the

pathophysiology of diabetic retinopathy. Hyperglycemia or high blood sugar levels leads to damage

to the retinal small vessels and the endothelial cells.

This damage to the small vessels in the retina leads to more permeability of the vessels.

So things leak out of that blood vessels.

This causes blot hemorrhages, which are small hemorrhages in the retina,

and also the formation of hard exudates. And hard exudates are yellow-white deposits of lipids

in the retina. Damage to the blood vessel walls leads to micro aneurysms, so small pouches

forming in the blood vessels, and also something

called Venus Beeding. Venus Beeding is where the walls of the veins are no longer straight

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

There's also damage to nerve fibres in the retina, which causes fluffy white patches

to form on the retina which are called cotton wall spots. And these cotton wool spots are quite

typical of diabetic retinopathy, and again it's because of damage to the nerve fibers. Something

called intrametinal microvascular abnormalities or IMRA

is where there is dilated and torturous capillaries in the retina.

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