Atlas of Ophthalmology

Proliferative Diabetic Retinopathy with Preretinal Hemorrhage (Colour Photography Posterior Segment, Fluorescein angiography , OCT)

Systemic Diseases -> Endocrine Disorders -> Diabetes Mellitus -> Retina -> Proliferative (PDR)
Patient: 59 years of age, male, BCVA 0.1, IOP 18 mmHg. Ocular Medical History: cataract surgery and antiVEGF injection in 04/2014, retinal Laser therapy in 05/2014, decrease of vision in 08/2015. General Medical History: diabetes since 20 years, oral anti diabetic therapy. Main Complaint: vision loss. Purpose: to present proliferative diabetic retinopathy with preretinal hemorrhage. Methods: Colour Photography Posterior Segment, Fluorescein angiography HRA , OCT Spectralis HRA Findings: Colour Photography Posterior Segment: preretinal hemorrhage, multiple deep, blot hemorrhages, retinal proliferative vessels including fibrous proliferation, hard exsudates, areas of past laser treatment. Fluorescein Angiography HRA: retinal and optic disk neovascularization , parapapillary non-perfusion areas. OCT: preretinal hemorrhage. Discussion: Rebecca L Thomas et al. (1) determined the prevalence and severity of diabetic retinopathy in a cross-sectional analysis of about 90.000 persons with diabetes. They found a prevalence of any DR and sight-threatening DR in type 2 diabetes of 30% and 3%, respectively. The presence of DR was strongly associated with increasing duration of diabetes and with insulin therapy. Stratton IM (2) combined the results from 2 consecutive years of photographic screening enabling estimation of the risk of future development of sight threatening DR. They found that patients with background DR in both eyes at both screenings, 11% per year progressed to sight threatening DR. Literature: (1) Rebecca L Thomas, Frank D Dunstan, Stephen D Luzio, Sharmistha Roy Chowdhury, Rachel V North, Sarah L Hale, Robert L Gibbins, David R Owens. Prevalence of diabetic retinopathy within a national diabetic retinopathy screening service. Br J Ophthalmol2015;99:64-68 doi:10.1136/bjophthalmol-2013-304017 (2) Stratton IM, Aldington SJ, Taylor DJ, Adler AI, Scanlon PH. A simple risk stratification for time to development of sight-threatening diabetic retinopathy. Diabetes Care. 2013 Mar;36(3):580-5

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