Non-perfusion in Far Periphery and Vitreous Hemorrhage
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67-year-old man has proliferative diabetic retinopathy in both eyes with vitreous hemorrhage in the left eye. He has had pan retinal laser in the left eye. The vitreous hemorrhage has been there for greater than two years and his vision is still hazy. He takes Lumigan in both eyes for his glaucoma.
VISUAL ACUITY: OD 20/40, OS 20/40. IOP: OD 12, OS 11. The right eye has a posterior chamber intraocular lens in good position, as does the left eye.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.8. There is neovascularization on the inferior and superior pole of the optic nerve.
The macula is dry. There are ischemic changes in the periphery including ghost vessels.
OS: Vertical C/D ratio is 0.8. There is a 2+ vitreous hemorrhage. There is partial pan retinal laser.
OCT SCAN: The OCT scan of the right eye shows the macula to be flat. The left eye shows a stable macular pucker. Photos confirm clinical findings.
FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows leakage from the neovascularization on the nerve in the right eye and in the inferotemporal of the macula in the left eye and also the peripherals sweeps in the right eye show significant non perfusion, especially inferonasally.
IMPRESSION:
1. PROLIFERATIVE DIABETIC RETINOPATHY – BOTH EYES
2. NON CLEARING MILD VITREOUS HEMORRHAGE – LEFT EYE
3. GLAUCOMA
DISCUSSION: I explained to the patient with the proliferative retinopathy in the right eye, he has a high risk of vision loss, especially given that he has blood already in his left eye. I would like to protect the right eye from a similar fate. I started pan retinal laser in the right eye today
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Proliferative Diabetic Retinopathy Both Eyes - Vitreous Hemorrahge Left Eye537 views67-year-old man has proliferative diabetic retinopathy in both eyes with vitreous hemorrhage in the left eye. He has had pan retinal laser in the left eye. The vitreous hemorrhage has been there for greater than two years and his vision is still hazy. He takes Lumigan in both eyes for his glaucoma.
VISUAL ACUITY: OD 20/40, OS 20/40
(0 votes)
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Proliferative Diabetic Retinopathy Both Eyes - Vitreous Hemorrahge Left Eye435 views67-year-old man has proliferative diabetic retinopathy in both eyes with vitreous hemorrhage in the left eye. He has had pan retinal laser in the left eye. The vitreous hemorrhage has been there for greater than two years and his vision is still hazy. He takes Lumigan in both eyes for his glaucoma.
VISUAL ACUITY: OD 20/40, OS 20/40
(0 votes)
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Proliferative Diabetic Retinopathy Both Eyes - Vitreous Hemorrahge Left Eye407 views67-year-old man has proliferative diabetic retinopathy in both eyes with vitreous hemorrhage in the left eye. He has had pan retinal laser in the left eye. The vitreous hemorrhage has been there for greater than two years and his vision is still hazy. He takes Lumigan in both eyes for his glaucoma.
VISUAL ACUITY: OD 20/40, OS 20/40
(0 votes)
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Proliferative Diabetic Retinopathy Both Eyes - Vitreous Hemorrahge Left Eye440 views67-year-old man has proliferative diabetic retinopathy in both eyes with vitreous hemorrhage in the left eye. He has had pan retinal laser in the left eye. The vitreous hemorrhage has been there for greater than two years and his vision is still hazy. He takes Lumigan in both eyes for his glaucoma.
VISUAL ACUITY: OD 20/40, OS 20/40
(0 votes)
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Proliferative Diabetic Retinopathy Both Eyes - Vitreous Hemorrahge Left Eye423 views67-year-old man has proliferative diabetic retinopathy in both eyes with vitreous hemorrhage in the left eye. He has had pan retinal laser in the left eye. The vitreous hemorrhage has been there for greater than two years and his vision is still hazy. He takes Lumigan in both eyes for his glaucoma.
VISUAL ACUITY: OD 20/40, OS 20/40
(0 votes)
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Proliferative Diabetic Retinopathy Both Eyes - Vitreous Hemorrahge Left Eye386 views67-year-old man has proliferative diabetic retinopathy in both eyes with vitreous hemorrhage in the left eye. He has had pan retinal laser in the left eye. The vitreous hemorrhage has been there for greater than two years and his vision is still hazy. He takes Lumigan in both eyes for his glaucoma.
VISUAL ACUITY: OD 20/40, OS 20/40
(0 votes)
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Proliferative Diabetic Retinopathy Both Eyes - Vitreous Hemorrahge Left Eye384 views67-year-old man has proliferative diabetic retinopathy in both eyes with vitreous hemorrhage in the left eye. He has had pan retinal laser in the left eye. The vitreous hemorrhage has been there for greater than two years and his vision is still hazy. He takes Lumigan in both eyes for his glaucoma.
VISUAL ACUITY: OD 20/40, OS 20/40
(0 votes)
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Proliferative Diabetic Retinopathy Both Eyes - Vitreous Hemorrahge Left Eye437 views67-year-old man has proliferative diabetic retinopathy in both eyes with vitreous hemorrhage in the left eye. He has had pan retinal laser in the left eye. The vitreous hemorrhage has been there for greater than two years and his vision is still hazy. He takes Lumigan in both eyes for his glaucoma.
VISUAL ACUITY: OD 20/40, OS 20/40
(0 votes)
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Proliferative Diabetic Retinopathy Both Eyes - Vitreous Hemorrahge Left Eye376 views67-year-old man has proliferative diabetic retinopathy in both eyes with vitreous hemorrhage in the left eye. He has had pan retinal laser in the left eye. The vitreous hemorrhage has been there for greater than two years and his vision is still hazy. He takes Lumigan in both eyes for his glaucoma.
VISUAL ACUITY: OD 20/40, OS 20/40
(0 votes)
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Proliferative Diabetic Retinopathy Both Eyes - Vitreous Hemorrahge Left Eye400 views67-year-old man has proliferative diabetic retinopathy in both eyes with vitreous hemorrhage in the left eye. He has had pan retinal laser in the left eye. The vitreous hemorrhage has been there for greater than two years and his vision is still hazy. He takes Lumigan in both eyes for his glaucoma.
VISUAL ACUITY: OD 20/40, OS 20/40
(0 votes)
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Proliferative Diabetic Retinopathy Both Eyes - Vitreous Hemorrahge Left Eye368 views67-year-old man has proliferative diabetic retinopathy in both eyes with vitreous hemorrhage in the left eye. He has had pan retinal laser in the left eye. The vitreous hemorrhage has been there for greater than two years and his vision is still hazy. He takes Lumigan in both eyes for his glaucoma.
VISUAL ACUITY: OD 20/40, OS 20/40
(0 votes)
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Proliferative Diabetic Retinopathy Both Eyes - Vitreous Hemorrahge Left Eye416 views67-year-old man has proliferative diabetic retinopathy in both eyes with vitreous hemorrhage in the left eye. He has had pan retinal laser in the left eye. The vitreous hemorrhage has been there for greater than two years and his vision is still hazy. He takes Lumigan in both eyes for his glaucoma.
VISUAL ACUITY: OD 20/40, OS 20/40
(0 votes)
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Proliferative Diabetic Retinopathy Both Eyes - Vitreous Hemorrahge Left Eye - Dark Area is Non-Perfusion399 views67-year-old man has proliferative diabetic retinopathy in both eyes with vitreous hemorrhage in the left eye. He has had pan retinal laser in the left eye. The vitreous hemorrhage has been there for greater than two years and his vision is still hazy. He takes Lumigan in both eyes for his glaucoma.
VISUAL ACUITY: OD 20/40, OS 20/40
(0 votes)
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Proliferative Diabetic Retinopathy Both Eyes - Vitreous Hemorrahge Left Eye - Dark Area is Non-Perfusion419 views67-year-old man has proliferative diabetic retinopathy in both eyes with vitreous hemorrhage in the left eye. He has had pan retinal laser in the left eye. The vitreous hemorrhage has been there for greater than two years and his vision is still hazy. He takes Lumigan in both eyes for his glaucoma.
VISUAL ACUITY: OD 20/40, OS 20/40
(0 votes)
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Proliferative Diabetic Retinopathy Both Eyes - Vitreous Hemorrahge Left Eye380 views67-year-old man has proliferative diabetic retinopathy in both eyes with vitreous hemorrhage in the left eye. He has had pan retinal laser in the left eye. The vitreous hemorrhage has been there for greater than two years and his vision is still hazy. He takes Lumigan in both eyes for his glaucoma.
VISUAL ACUITY: OD 20/40, OS 20/40
(0 votes)
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Proliferative Diabetic Retinopathy Both Eyes - Vitreous Hemorrahge Left Eye401 views67-year-old man has proliferative diabetic retinopathy in both eyes with vitreous hemorrhage in the left eye. He has had pan retinal laser in the left eye. The vitreous hemorrhage has been there for greater than two years and his vision is still hazy. He takes Lumigan in both eyes for his glaucoma.
VISUAL ACUITY: OD 20/40, OS 20/40
(0 votes)
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Proliferative Diabetic Retinopathy Both Eyes - Vitreous Hemorrahge Left Eye414 views67-year-old man has proliferative diabetic retinopathy in both eyes with vitreous hemorrhage in the left eye. He has had pan retinal laser in the left eye. The vitreous hemorrhage has been there for greater than two years and his vision is still hazy. He takes Lumigan in both eyes for his glaucoma.
VISUAL ACUITY: OD 20/40, OS 20/40
(0 votes)
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Proliferative Diabetic Retinopathy Both Eyes - Vitreous Hemorrahge Left Eye455 views67-year-old man has proliferative diabetic retinopathy in both eyes with vitreous hemorrhage in the left eye. He has had pan retinal laser in the left eye. The vitreous hemorrhage has been there for greater than two years and his vision is still hazy. He takes Lumigan in both eyes for his glaucoma.
VISUAL ACUITY: OD 20/40, OS 20/40
(0 votes)
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Proliferative Diabetic Retinopathy Both Eyes - Vitreous Hemorrahge Left Eye - Vessel Leaking Fluorescein565 views67-year-old man has proliferative diabetic retinopathy in both eyes with vitreous hemorrhage in the left eye. He has had pan retinal laser in the left eye. The vitreous hemorrhage has been there for greater than two years and his vision is still hazy. He takes Lumigan in both eyes for his glaucoma.
VISUAL ACUITY: OD 20/40, OS 20/40
(0 votes)
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Proliferative Diabetic Retinopathy Both Eyes - Vitreous Hemorrahge Left Eye483 views67-year-old man has proliferative diabetic retinopathy in both eyes with vitreous hemorrhage in the left eye. He has had pan retinal laser in the left eye. The vitreous hemorrhage has been there for greater than two years and his vision is still hazy. He takes Lumigan in both eyes for his glaucoma.
VISUAL ACUITY: OD 20/40, OS 20/40
(0 votes)
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Proliferative Diabetic Retinopathy Both Eyes - Vitreous Hemorrahge Left Eye - Dark Area is Vitreous Hemorrhage541 views67-year-old man has proliferative diabetic retinopathy in both eyes with vitreous hemorrhage in the left eye. He has had pan retinal laser in the left eye. The vitreous hemorrhage has been there for greater than two years and his vision is still hazy. He takes Lumigan in both eyes for his glaucoma.
VISUAL ACUITY: OD 20/40, OS 20/40
(0 votes)
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67-year-old man has proliferative diabetic retinopathy in both eyes with vitreous hemorrhage in the left eye. He has had pan retinal laser in the left eye. The vitreous hemorrhage has been there for greater than two years and his vision is still hazy. He takes Lumigan in both eyes for his glaucoma.
VISUAL ACUITY: OD 20/40, OS 20/40. IOP: OD 12, OS 11. The right eye has a posterior chamber intraocular lens in good position, as does the left eye.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.8. There is neovascularization on the inferior and superior pole of the optic nerve.
The macula is dry. There are ischemic changes in the periphery including ghost vessels.
OS: Vertical C/D ratio is 0.8. There is a 2+ vitreous hemorrhage. There is partial pan retinal laser.
OCT SCAN: The OCT scan of the right eye shows the macula to be flat. The left eye shows a stable macular pucker. Photos confirm clinical findings.
FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows leakage from the neovascularization on the nerve in the right eye and in the inferotemporal of the macula in the left eye and also the peripherals sweeps in the right eye show significant non perfusion, especially inferonasally.
IMPRESSION:
1. PROLIFERATIVE DIABETIC RETINOPATHY – BOTH EYES
2. NON CLEARING MILD VITREOUS HEMORRHAGE – LEFT EYE
3. GLAUCOMA
DISCUSSION: I explained to the patient with the proliferative retinopathy in the right eye, he has a high risk of vision loss, especially given that he has blood already in his left eye. I would like to protect the right eye from a similar fate. I started pan retinal laser in the right eye today
