Clinical Case 3

DIABETIC RETINOPATHY

Proliferative Diabetic Retinopathy in Type 1 Diabetes - Clinical Case 3

Proliferative diabetic retinopathy in a 25-years-old female patient, with diabetes diagnosed 13 years ago. This patient had four episodes of hyperglycemic coma. Note the retinal neovascularization, hemorrhage and severe neovascularization of the optic disc. Visual acuity: 20/200 RE.

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Fundus photograph, 2 months after vitreoretinal surgery. Visual acuity: 20/40 LE.

Evaluations

1st Evaluation - 04 02 2011

Autofluorescence

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Infrared

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Red-free

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Biometry

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Microperimetry

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OCT (B-Scan) longitudinal

Cystoid macular edema and retinal pigment epithelium detachment.

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Colour Retinography

Fundus shows some laser treatment in the retinal periphery. Note the neovascularization at the optic disc. We recomended treatment with laser photocoagulation. Visual acuity: 20/200 RE.

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Tonometry

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2nd Evaluation - 09 02 2011

Fluorescein Angiography

Multiple ischemic areas, retinal neovascularization and leakage at optic disc.

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Infrared

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Red-free

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Anterior Segment Photo

No iris neovascularization.

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OCT (B-Scan) longitudinal

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Colour Retinography

Vitreous hemorrhage (LE).

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3rd Evaluation - 16 03 2011

OCT (B-Scan) longitudinal

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Colour Retinography

Neovascularization, microaneuryms and retinal hemorrhages. HbA1c=6,3%. She was submitted to laser photocoagulation.

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4th Evaluation - 27 04 2011

Autofluorescence

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Infrared

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Red-free

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OCT (B-Scan) longitudinal

Severe cystoid macular edema.

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Colour Retinography

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5th Evaluation - 03 05 2011

Autofluorescence

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Infrared

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Red-free

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OCT (B-Scan) longitudinal

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Colour Retinography

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6th Evaluation - 21 06 2011

Autofluorescence

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Infrared

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Red-free

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OCT (B-Scan) longitudinal

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Colour Retinography

Visual acuity: 20/200 RE. Another vitreous hemorrhage (RE). HbA1c was 7,6%.

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7th Evaluation - postoperative - 04 02 2011

Autofluorescence

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Infrared

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Red-free

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Biometry

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OCT (B-Scan) longitudinal

Serous retinal detachment.

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Colour Retinography

One day after vitrectomy, removal of fibrovascular tissue and laser photocoagulation.

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8th Evaluation - 18 11 2011

Colour Retinography

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Tonometry

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9th Evaluation - postoperative - 25 11 2011

Autofluorescence

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Infrared

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Red-free

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Anterior Segment Photo

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OCT (B-Scan) longitudinal

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Colour Retinography

One day after vitrectomy, removal of fibrovascular tissue and laser photocoagulation (LE).

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10th Evaluation - 24 01 2012

Autofluorescence

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Infrared

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Red-free

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Anterior Segment Photo

VA: 20/40 RE, 20/50 LE.

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OCT (B-Scan) longitudinal

Recovery of retinal structure.

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Colour Retinography

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11th Evaluation - 06 02 2013

OCT (B-Scan) longitudinal

HbA1c: 7.9 %. VA: 20/50 RE; 20/60 LE.

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Colour Retinography

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12th Evaluation - 01 04 2014

OCT (B-Scan) longitudinal

VA: 20/50c RLE.

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Colour Retinography

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