Diabetic Retinopathy – Clinical and Imaging Correlation
Dr. Sarang Lambat, Dr. Vinay Nangia Suraj Eye Institute, 559 New colony, Nagpur, India
Case Description A male, 54 years of age, came with floaters in the left eye since 2 days. He was a known diabetic under treatment since 10 years. On examination his BCVA was 6/6p in OD and 6/9p in OS. IOP with applanation tonometry was 16 mmHg in OU. Fundus examination revealed features of proliferative diabetic retinopathy with maculopathy in OU. A fluorescein angiography and SDOCT was done to assess and document the retinopathy.
On the basis of this patient was diagnosed to have both eyes proliferative diabetic retinopathy with right eye non centre involving macular edema. He underwent both eyes injection antiVEGF followed by pan retinal photocoagulation and modified grid macular laser for the right eye. Patient missed the follow ups and reviewed with us after 2 years with blurring of vision in both eyes. On examination his BCVA was 6/36 in both eyes. Anterior segment was WNL. IOP was normal.
On the basis of this a plan of right eye injection antiVEGF followed by vitrectomy and left eye injection antiVEGF followed by macular laser
After undergoing intervention at initial presentation, patient responded well but didn’t follow up for routine examination. At subsequent follow up he had significant macular edema in the right eye along with epiretinal membrane and vitreomacular traction and hence a surgical intervention was done. Post surgery he did well and the macular architecture was much better. Left eye had more of cystoid with diffuse retinal thickening and hence he underwent antiVEGF injection which helped in resolution of macular edema. SDOCT has been imperative in categorising various morphological types of diabetic macular edema. This helps us in planning a tailored approach for each patient for efficient management of such cases.
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Dr. Sarang Lambat MS, FRF Consultant Vitreoretinal services Suraj Eye Institute Nagpur Email –firstname.lastname@example.org