Proliferative Diabetic Retinopathy - Lacy Neovascularization of the Disc - Photo of Fresh Panretinal (Scatter) Photocoagulation
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64-year-old woman was seen 6 months ago, still with vision loss right eye. She has been diabetic for eleven years. Her hemoglobin A1Cs are running high lately. She had laser done in Texas. She relocated back to Florida now permanently. The right eye does have a central scotoma dating back to the laser treatment done about a year ago.
VISUAL ACUITY: OD 20/63, OS 20/40. IOP: OD 17, OS 13. There is 3+ nuclear sclerosis in both eyes.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.0. There is no posterior vitreous separation and rare retinal hemorrhages.
OS: Vertical C/D ratio is 0.2. There is no posterior vitreous separation and rare retinal hemorrhages. There is new NVD.
SPECTRALIS-SD-OCT SCAN: The OCT scan of the right eye does show an epiretinal membrane where there is a central area of photoreceptor defect neatly under the center of the macula. The left eye shows an epiretinal membrane with vitreoretinal traction and a partial evolving posterior vitreous separation. The photos in the right eye show patchy retinal hemorrhages. In the left eye there is light laser and there is an epiretinal membrane.
FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows multiple microaneurysms in each eye with light laser. The left eye does have a diffuse leakage from the macula, which looks more like tractional leakage than diabetic leakage. I see very few microaneurysms near the fovea. The left has leakage from NVD and nonperfusion inferonasally.
IMPRESSION:
1. BACKGROUND DIABETIC RETINOPATHY – OD; PDR OS.
2. VITREOMACULAR TRACTION – LEFT EYE
3. EPIRETINAL MEMBRANE – LEFT EYE
4. MACULAR EDEMA – LEFT EYE
5. CATARACT
6. CENTRAL SCOTOMA – RIGHT EYE
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64-year-old woman was seen 6 months ago, still with vision loss right eye. She has been diabetic for eleven years. Her hemoglobin A1Cs are running high lately. She had laser done in Texas. She relocated back to Florida now permanently. The right eye does have a central scotoma dating back to the laser treatment done about a year ago.
VISUAL ACUITY: OD 20/63, OS 20/40. IOP: OD 17, OS 13. There is 3+ nuclear sclerosis in both eyes.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.0. There is no posterior vitreous separation and rare retinal hemorrhages.
OS: Vertical C/D ratio is 0.2. There is no posterior vitreous separation and rare retinal hemorrhages. There is new NVD.
SPECTRALIS-SD-OCT SCAN: The OCT scan of the right eye does show an epiretinal membrane where there is a central area of photoreceptor defect neatly under the center of the macula. The left eye shows an epiretinal membrane with vitreoretinal traction and a partial evolving posterior vitreous separation. The photos in the right eye show patchy retinal hemorrhages. In the left eye there is light laser and there is an epiretinal membrane.
FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows multiple microaneurysms in each eye with light laser. The left eye does have a diffuse leakage from the macula, which looks more like tractional leakage than diabetic leakage. I see very few microaneurysms near the fovea. The left has leakage from NVD and nonperfusion inferonasally.
IMPRESSION:
1. BACKGROUND DIABETIC RETINOPATHY – OD; PDR OS.
2. VITREOMACULAR TRACTION – LEFT EYE
3. EPIRETINAL MEMBRANE – LEFT EYE
4. MACULAR EDEMA – LEFT EYE
5. CATARACT
6. CENTRAL SCOTOMA – RIGHT EYE
