Case #41 – Diabetic Retinopathy – Panoramic Imaging of Rapid Progression

BCVA was Finger Counting at 1 ft in the right eye with the vitreous hemorrhage (as seen on the last page) and 20/400 in the left eye seen above. Note the increase in the number and size of the hemorrhages above.

Although the patient was given an appointment 2 months after the laser treatments, she failed to return even after mail and telephone recall. About 16 months later, she returned complaining of blurred vision over the past several months in both eyes and sudden vision loss in the right eye for several days. Again

Case 1: Optomap® Fluorescein Angiography Comparison OD and OS 1 month after V1

Case 1: Optomap® Fluorescein Angiography OS 1 month after V1 Focal laser in the para-macula area was recommended and performed in each eye. The patient was informed about the risk of vision loss with progression of diabetic retinopathy. Careful control of her blood glucose level and her high blood pressure was stressed. The patient

Case 1: Optomap® Fluorescein Angiography OD 1 month after V1 A Fluorescein angiogram was obtained a month later. It revealed diffuse leakage as shown.

In addition to the dot and blot hemorrhages, the left fundus revealed several cotton wool spots, two of which were in the superior temporal arcade. Some areas of possible IRMA (intra-retinal microvascular anomalies) were noted.

Patient reported a recent blood glucose was measured at 200 and blood pressure at 130/80. Best corrected visual acuity with -5.00 RE and LE was 20/30. The fundus revealed mild non-proliferative diabetic retinopathy with scattered dot and blot hemorrhages as well as several cotton wool spots more obvious in the left eye.

A 42-year-old myopic Hispanic female presented for a contact lens check-up. She reported mild blurred vision in each eye. She gave a history of diabetes of 6 years duration and mild systemic hypertension, both of which were being treated by her internist with "several pills."