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DIABETIC RETINOPATHY

Proliferative Diabetic Retinopathy in Type 1 Diabetes

Clinical Case 03

Proliferative Diabetic Retinopathy in Type 1 Diabetes - Clinical Case 03

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

Proliferative Diabetic Retinopathy in Type 1 Diabetes - Clinical Case 03

Fundus photograph, 2 months after vitreoretinal surgery. VA:20/40 RE

Evaluations

1st evaluation

24 0

04 02 2011 - Autofluorescence

Autofluorescence photograph showing macular changes

Autofluorescence photograph showing macular changes

04 02 2011 - Biometry

04 02 2011 - Colour Retinography

Ultra-widefield photograph of 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, macular edema, and severe neovascularization of the optic disc. Fundus shows some laser treatment in the retinal periphery. Visual acuity: 20/200 RE

Ultra-widefield photograph of 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, macular edema, and severe neovascularization of the optic disc. Fundus shows some laser treatment in the retinal periphery. Visual acuity: 20/200 RE

Ultra-widefield photograph (amplification) of 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, macular edema, and severe neovascularization of the optic disc. Fundus shows some laser treatment in the retinal periphery. Visual acuity was 20/200 RE

Ultra-widefield photograph (magnification) of 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, macular edema, and severe neovascularization of the optic disc. Fundus shows some laser treatment in the retinal periphery. Visual acuity was 20/200 RE

Fundus photograph of proliferative diabetic retinopathy in type 1 diabetes. Note the neovascularization at the optic disc. We recomended treatment with laser photocoagulation

Fundus photograph of proliferative diabetic retinopathy in type 1 diabetes. Note the neovascularization at the optic disc. We recomended treatment with laser photocoagulation

04 02 2011 - Infrared

04 02 2011 - Microperimetry

Right eye microperimetry

Left eye microperimetry

04 02 2011 - OCT B-Scan (Longitudinal)

OCT line-scan showing cystoid macular edema and retinal pigment epithelium detachment

OCT line-scan showing cystoid macular edema and retinal pigment epithelium detachment

OCT line-scan showing cystoid macular edema and retinal pigment epithelium detachment

OCT line-scan showing cystoid macular edema and retinal pigment epithelium detachment

OCT line-scan showing cystoid macular edema and retinal pigment epithelium detachment

OCT line-scan showing cystoid macular edema and retinal pigment epithelium detachment

OCT line-scan showing cystoid macular edema and retinal pigment epithelium detachment

OCT line-scan showing cystoid macular edema and retinal pigment epithelium detachment

04 02 2011 - Red-free

04 02 2011 - Tonometry

2nd evaluation

21 0

09 02 2011 - Anterior Segment Photo

Anterior segment photograph of left eye shows no iris neovascularization

16 02 2011 - Colour Retinography

Ultra-widefield photograph showing vitreous hemorrhage

Ultra-widefield photograph after laser treatment in same case

09 02 2011 - Fluorescein Angiography

Fluorescein angiogram at early phase. Note multiple ischemic areas and neovascularization both on the optic disc and elsewhere

Fluorescein angiogram at early phase. Note multiple ischemic areas and neovascularization both on the optic disc and elsewhere

Fluorescein angiogram at mid-phase showing multiple ischemic areas, retinal neovascularization and leakage at optic disc

Fluorescein angiogram at early phase on left eye. Note the retinal neovascularization and areas of ischemia

Fluorescein angiogram (ultra-widefield) at late stage. Note the multiple ischemic retinal areas and areas of exudation

Fluorescein angiogram (ultra-widefield) at late stage. Note the multiple ischemic retinal areas and areas of exudation

16 02 2011 - Infrared

09 02 2011 - OCT B-Scan (Longitudinal)

OCT line-scan showing cystoid macular edema and retinal pigment epithelium detachment

OCT line-scan showing cystoid macular edema and retinal pigment epithelium detachment

OCT line-scan showing cystoid macular edema and retinal pigment epithelium detachment

OCT line-scan showing cystoid macular edema and retinal pigment epithelium detachment

16 02 2011 - Red-free

3rd evaluation

12 0

16 03 2011 - Colour Retinography

Fundus photograph showing neovascularization, microaneuryms and retinal hemorrhages. HbA1c=6,3%. She was submitted to laser photocoagulation

Fundus photograph showing neovascularization, microaneuryms and retinal hemorrhages. HbA1c=6,3%. She was submitted to laser photocoagulation

Fundus photograph showing retinal hemorrhages. She will submmited to laser photocoagulation

The left eye will also be submmited to laser photocoagulation

16 03 2011 - OCT B-Scan (Longitudinal)

OCT vertical line-scan showing macular edema and retinal pigmented epithelium detachment

OCT horizontal line-scan shows macular edema and retinal pigmented epithelium detachment

OCT horizontal line-scan shows macular edema

OCT line-scan shows macular edema and retinal pigmented epithelium detachment

OCT vertical line-scan shows macular edema and retinal pigmented epithelium detachment

OCT line-scan shows macular edema and retinal pigmented epithelium detachment

OCT horizontal line-scan shows macular edema and retinal pigmented epithelium detachment

OCT line-scan shows macular edema and retinal pigmented epithelium detachment

4th evaluation

16 0

27 04 2011 - Autofluorescence

27 04 2011 - Colour Retinography

Proliferative diabetic retinopathy

Fundus photograph of proliferative diabetic retinopathy

27 04 2011 - Infrared

27 04 2011 - OCT B-Scan (Longitudinal)

Severe cystoid macular edema

OCT line-scan showing severe cystoid macular edema

OCT line-scan showing severe cystoid macular edema

27 04 2011 - Red-free

5th evaluation

20 0

03 05 2011 - Autofluorescence

03 05 2011 - Colour Retinography

03 05 2011 - Infrared

03 05 2011 - OCT B-Scan (Longitudinal)

OCT vertical line-scan shows severe macular edema

03 05 2011 - Red-free

6th evaluation

19 0

21 06 2011 - Autofluorescence

21 06 2011 - Colour Retinography

Note retinal neovascularization, hemorrhage and severe neovascularization of the optic disc. Visual acuity: 20/200 RE

Note retinal neovascularization, hemorrhage and severe neovascularization of the optic disc. Visual acuity: 20/200 RE

Note retinal neovascularization, hemorrhage and severe neovascularization of the optic disc. Visual acuity was 20/200 RE

Note retinal neovascularization, hemorrhage and severe neovascularization of the optic disc

Ultra-widefield photograph showing another vitreous hemorrhage. HbA1c was 7,6%

21 06 2011 - Infrared

21 06 2011 - OCT B-Scan (Longitudinal)

21 06 2011 - Red-free

7th evaluation - postoperative

20 0

04 11 2011 - Autofluorescence

26 10 2011 - Biometry

21 10 2011 - Colour Retinography

Ultra-widefield photograph, 1 day after vitrectomy, removal of fibrovascular tissue and laser photocoagulation

Fundus photograph, 1 day after vitrectomy, removal of fibrovascular tissue and laser photocoagulation

Fundus photograph 2 weeks after vitreoretinal surgery

04 11 2011 - Infrared

04 11 2011 - OCT B-Scan (Longitudinal)

OCT vertical line-scan shows serous retinal detachment

OCT vertical line-scan shows serous retinal detachment

OCT vertical line-scan shows serous retinal detachment

OCT vertical line-scan shows serous retinal detachment

OCT vertical line-scan shows serous retinal detachment

04 11 2011 - Red-free

04 11 2011 - Refraction

8th evaluation

5 0

18 11 2011 - Colour Retinography

One month after surgery

Ultra-widefield fundus photograph showing vitreous hemorrhage. We recommended vitreoretinal surgery

Fundus photograph showing vitreous hemorrhage. We recommended vitreoretinal surgery

18 11 2011 - Tonometry

9th evaluation - postoperative

16 0

25 11 2011 - Anterior Segment Photo

Anterior segment photograph, 1 day after vitreoretinal surgery (LE)

25 11 2011 - Autofluorescence

25 11 2011 - Colour Retinography

Ultra-widefield photograph, 1 day after vitrectomy, removal of fibrovascular tissue and laser photocoagulation

Fundus photograph 1 day after vitrectomy, removal of fibrovascular tissue and laser photocoagulation

25 11 2011 - Infrared

25 11 2011 - OCT B-Scan (Longitudinal)

25 11 2011 - Red-free

10th evaluation

20 0

24 01 2012 - Anterior Segment Photo

VA: 20/40 RE, 3 months after vitreoretinal surgery.

VA 20/50 LE, 2 months after vitreoretinal surgery.

24 01 2012 - Autofluorescence

24 01 2012 - Colour Retinography

Ultra-widefield photograph 3 months after vitreoretinal surgery. Visual acuity: 20/40 RE

Ultra-widefield photograph, 2 months after vitreoretinal surgery. Visual acuity was 20/50 LE

Fundus photograph,3 months after vitreoretinal surgery

Fundus photograph 2 month after vitreoretinal surgery

24 01 2012 - Infrared

24 01 2012 - OCT B-Scan (Longitudinal)

OCT line-scan 2 months after vitreoretinal surgery showing recovery of retinal structure

OCT line-scan showing minimal macular edema

OCT line-scan 2 months after vitreoretinal surgery showing recovery of retinal structure

OCT line-scan 2 months after vitreoretinal surgery showing recovery of retinal structure

24 01 2012 - Red-free

11th evaluation

8 0

06 02 2013 - Colour Retinography

Ultra-widefield photograph

Ultra-widefield photograph

06 02 2013 - OCT B-Scan (Longitudinal)

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

12th evaluation

8 0

01 04 2014 - Colour Retinography

01 04 2014 - OCT B-Scan (Longitudinal)

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