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Derniers ajouts - NVD - Neovascularization of the Disc - Macular Edema

57-year-old man has diabetic retinopathy in both eyes. Diabetic for 14 years with HgB A1C often over 10. VISUAL ACUITY: OD 20/30, OS 20/40. IOP: OD 11, OS 12. The right eye has a posterior chamber intraocular lens in good position. The left eye has 1+ nuclear sclerosis. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.1. There are multiple microaneurysms and light laser and patchy hemorrhages. There is also exudate inferotemporal to the fovea. OS: Vertical C/D ratio is 0.0. There is neovascularization on the nerve extending about a disc and a half diameter off the nerve. There is also patchy microaneurysms and light laser. OCT SCAN: The OCT scan of the right eye shows a normal central foveal thickness. The left eye however, does show macular edema centrally. Photos confirm clinical findings. FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows leaking microaneurysms in each eye, as well as leakage from the neovascularization in the left eye. IMPRESSION: 1. PROLIFERATIVE DIABETIC RETINOPATHY – LEFT EYE 2. CLINICALLY SIGNIFICANT MACULAR EDEMA – LEFT EYE 3. BACKGROUND DIABETIC RETINOPATHY – RIGHT EYE DISCUSSION: I explained to the patient that unfortunately the macula in the left eye has edema affecting the center of the fovea. I treated that eye with laser to try and control the edema and prevent further vision loss and possibly improve the vision. In addition, because of the proliferative diabetic retinopathy, the left eye needs to start pan retinal laser. I would like to allow the focal laser to take affect though and therefore I am going to have him return in about a month for evaluation and probable further laser

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PDR OS with NVEvu 786 fois57-year-old man has diabetic retinopathy in both eyes.
Diabetic for 14 years with HgB A1C often over 10.
VISUAL ACUITY: OD 20/30, OS 20/40. PDR OS BDR OD
27 Octobre 2010
pdr_nve_51677_282829.png
BDR OD with Edemavu 653 fois57-year-old man has diabetic retinopathy in both eyes.
Diabetic for 14 years with HgB A1C often over 10.
VISUAL ACUITY: OD 20/30, OS 20/40. PDR OS BDR OD
27 Octobre 2010
pdr_nve_51677_282729.png
BDR OD with Edemavu 661 fois57-year-old man has diabetic retinopathy in both eyes.
Diabetic for 14 years with HgB A1C often over 10.
VISUAL ACUITY: OD 20/30, OS 20/40. PDR OS BDR OD
27 Octobre 2010
pdr_nve_51677_282129.png
BDR OD with Edemavu 375 fois57-year-old man has diabetic retinopathy in both eyes.
Diabetic for 14 years with HgB A1C often over 10.
VISUAL ACUITY: OD 20/30, OS 20/40. PDR OS BDR OD
27 Octobre 2010
pdr_nve_51677_281929.png
PDR OS with NVEvu 383 fois57-year-old man has diabetic retinopathy in both eyes.
Diabetic for 14 years with HgB A1C often over 10.
VISUAL ACUITY: OD 20/30, OS 20/40. PDR OS BDR OD
27 Octobre 2010
pdr_nve_51677_281829.png
BDR OD with Edemavu 381 fois57-year-old man has diabetic retinopathy in both eyes.
Diabetic for 14 years with HgB A1C often over 10.
VISUAL ACUITY: OD 20/30, OS 20/40. PDR OS BDR OD
27 Octobre 2010
pdr_nve_51677_281729.png
PDR OS with NVEvu 382 fois57-year-old man has diabetic retinopathy in both eyes.
Diabetic for 14 years with HgB A1C often over 10.
VISUAL ACUITY: OD 20/30, OS 20/40. PDR OS BDR OD
27 Octobre 2010
pdr_nve_51677_281629.png
BDR OD with Edemavu 399 fois57-year-old man has diabetic retinopathy in both eyes.
Diabetic for 14 years with HgB A1C often over 10.
VISUAL ACUITY: OD 20/30, OS 20/40. PDR OS BDR OD
27 Octobre 2010
pdr_nve_51677_281329.png
PDR OS with NVEvu 349 fois57-year-old man has diabetic retinopathy in both eyes.
Diabetic for 14 years with HgB A1C often over 10.
VISUAL ACUITY: OD 20/30, OS 20/40. PDR OS BDR OD
27 Octobre 2010
pdr_nve_51677_281029.png
PDR OS with NVEvu 402 fois57-year-old man has diabetic retinopathy in both eyes.
Diabetic for 14 years with HgB A1C often over 10.
VISUAL ACUITY: OD 20/30, OS 20/40. PDR OS BDR OD
27 Octobre 2010
pdr_nve_51677_28929.png
PDR OS with NVEvu 385 fois57-year-old man has diabetic retinopathy in both eyes.
Diabetic for 14 years with HgB A1C often over 10.
VISUAL ACUITY: OD 20/30, OS 20/40. PDR OS BDR OD
27 Octobre 2010
pdr_nve_51677_28829.png
PDR OS with NVEvu 391 fois57-year-old man has diabetic retinopathy in both eyes.
Diabetic for 14 years with HgB A1C often over 10.
VISUAL ACUITY: OD 20/30, OS 20/40. PDR OS BDR OD
27 Octobre 2010
pdr_nve_51677_28729.png
PDR OS with NVEvu 440 fois57-year-old man has diabetic retinopathy in both eyes.
Diabetic for 14 years with HgB A1C often over 10.
VISUAL ACUITY: OD 20/30, OS 20/40. PDR OS BDR OD
27 Octobre 2010
pdr_nve_51677_28629.png
BDR OD with Edemavu 401 fois57-year-old man has diabetic retinopathy in both eyes.
Diabetic for 14 years with HgB A1C often over 10.
VISUAL ACUITY: OD 20/30, OS 20/40. PDR OS BDR OD
27 Octobre 2010
pdr_nve_51677_28529.png
PDR OS with NVEvu 509 fois57-year-old man has diabetic retinopathy in both eyes.
Diabetic for 14 years with HgB A1C often over 10.
VISUAL ACUITY: OD 20/30, OS 20/40. PDR OS BDR OD
27 Octobre 2010
pdr_nve_51677_28329.png
BDR OD with Edemavu 554 fois57-year-old man has diabetic retinopathy in both eyes.
Diabetic for 14 years with HgB A1C often over 10.
VISUAL ACUITY: OD 20/30, OS 20/40. PDR OS BDR OD
27 Octobre 2010
pdr_nve_51677_28129.jpg
PDR OS with NVEvu 1140 fois57-year-old man has diabetic retinopathy in both eyes.
Diabetic for 14 years with HgB A1C often over 10.
VISUAL ACUITY: OD 20/30, OS 20/40. PDR OS BDR OD
27 Octobre 2010
pdr_nve_51677.png
PDR OS with NVEvu 1283 fois57-year-old man has diabetic retinopathy in both eyes.
Diabetic for 14 years with HgB A1C often over 10.
VISUAL ACUITY: OD 20/30, OS 20/40. PDR OS BDR OD
27 Octobre 2010
   
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57-year-old man has diabetic retinopathy in both eyes. Diabetic for 14 years with HgB A1C often over 10. VISUAL ACUITY: OD 20/30, OS 20/40. IOP: OD 11, OS 12. The right eye has a posterior chamber intraocular lens in good position. The left eye has 1+ nuclear sclerosis. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.1. There are multiple microaneurysms and light laser and patchy hemorrhages. There is also exudate inferotemporal to the fovea. OS: Vertical C/D ratio is 0.0. There is neovascularization on the nerve extending about a disc and a half diameter off the nerve. There is also patchy microaneurysms and light laser. OCT SCAN: The OCT scan of the right eye shows a normal central foveal thickness. The left eye however, does show macular edema centrally. Photos confirm clinical findings. FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows leaking microaneurysms in each eye, as well as leakage from the neovascularization in the left eye. IMPRESSION: 1. PROLIFERATIVE DIABETIC RETINOPATHY – LEFT EYE 2. CLINICALLY SIGNIFICANT MACULAR EDEMA – LEFT EYE 3. BACKGROUND DIABETIC RETINOPATHY – RIGHT EYE DISCUSSION: I explained to the patient that unfortunately the macula in the left eye has edema affecting the center of the fovea. I treated that eye with laser to try and control the edema and prevent further vision loss and possibly improve the vision. In addition, because of the proliferative diabetic retinopathy, the left eye needs to start pan retinal laser. I would like to allow the focal laser to take affect though and therefore I am going to have him return in about a month for evaluation and probable further laser