1. B (Intravitreal anti-VEGF) & C (Pan-retinal laser photocoagulation)
The fundal photo shows retinal neovascularisation, thus the patient has proliferative diabetic retinopathy. The treatments for this are B & C. The former minimises further angiogenesis by blocking the effects of vascular endothelial growth factors (VEGFs). The latter induces regression of newly-formed vessels to reduce the risk of vitreous haemorrhage.
2. A, B, C, D & E!
- It is important to ask every diabetic patient about risk factors for diabetic retinopathy.
- Diabetic retinopathy can accelerate in pregnancy, so more frequent eye checks are needed.
- Good glycaemic and blood pressure control can be difficult but are very important
- All diabetic patients should have an annual eye check, so check with your patients!
- There are many lifestyle factors which slow down the progression of diabetic retinopathy. E.g. exercise, weight, dietary factors, not smoking.