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RETINOPHATIE DIABÉTIQUE

Rétinopathie Diabétique Proliférative – Type 1

Cas clinique 03

Rétinopathie Diabétique Proliférative – Type 1 - Cas clinique 03

Rétinopathie diabétique, chez un patient de 25 ans atteint de diabète diagnostiqué il y a 13 ans. Le patient a eu 4 épisodes de coma hyperglycémique. Notez la néovascularisation rétinienne, l'hémorragie et la néovascularisation sévère du disque optique. AV: 20/200 OD

Rétinopathie Diabétique Proliférative – Type 1 - Cas clinique 03

Rétinographie, 2 mois après la chirurgie vitréorétinienne. AV: 20/40 OD

Évaluations

1ère évaluation

24 0

04 02 2011 - Autofluorescence

Autofluorescence photograph showing macular changes

Autofluorescence photograph showing macular changes

04 02 2011 - Biométrie

04 02 2011 - Infrarouge

04 02 2011 - Micropérimétrie

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 - Rétinographie Couleur

Rétinopathie diabétique, chez un patient de 25 ans atteint de diabète diagnostiqué il y a 13 ans. Le patient a eu 4 épisodes de coma hyperglycémique. Notez la néovascularisation rétinienne, l'hémorragie et la néovascularisation sévère du disque optique. AV: 20/200 OD

Rétinopathie diabétique, chez un patient de 25 ans atteint de diabète diagnostiqué il y a 13 ans. Le patient a eu 4 épisodes de coma hyperglycémique. Notez la néovascularisation rétinienne, l'hémorragie et la néovascularisation sévère du disque optique. AV: 20/200 OD

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

Notez la néovascularisation du disque optique. Il est recommandé de traitement par photocoagulation laser

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 - Tonométrie

2ème évaluation

21 0

09 02 2011 - Angiographie à la Fluorescéine

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 - Infrarouge

09 02 2011 - OCT B-Scan (Longitudinal)

Oedème maculaire cystoïde et décollement de l'épithélium pigmentaire de la rétine

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

09 02 2011 - Photographie du Segment Antérieur

Aucune néovascularisation de l'iris

16 02 2011 - Red-free

16 02 2011 - Rétinographie Couleur

Ultra-widefield photograph showing vitreous hemorrhage

Ultra-widefield photograph after laser treatment in same case

3rd evaluation

12 0

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

16 03 2011 - Rétinographie Couleur

Néovascularisation, microanévrismes et hémorragies rétiniennes. HbA1c = 6,3%.

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

4ème évaluation

16 0

27 04 2011 - Autofluorescence

27 04 2011 - Infrarouge

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

27 04 2011 - Rétinographie Couleur

Rétinopathie diabétique proliférative

Fundus photograph of proliferative diabetic retinopathy

5ème évaluation

20 0

03 05 2011 - Autofluorescence

03 05 2011 - Infrarouge

03 05 2011 - OCT B-Scan (Longitudinal)

OCT vertical line-scan shows severe macular edema

03 05 2011 - Red-free

03 05 2011 - Rétinographie Couleur

6ème évaluation

19 0

21 06 2011 - Autofluorescence

21 06 2011 - Infrarouge

21 06 2011 - OCT B-Scan (Longitudinal)

21 06 2011 - Red-free

21 06 2011 - Rétinographie Couleur

Notez la néovascularisation rétinienne, l'hémorragie et la néovascularisation sévère du disque optique. AV: 20/200 OD

Notez la néovascularisation rétinienne, l'hémorragie et la néovascularisation sévère du disque optique. AV: 20/200 OD

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%

7ème évaluation - postopératoire

20 0

04 11 2011 - Autofluorescence

26 10 2011 - Biométrie

04 11 2011 - Infrarouge

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 - Réfraction

21 10 2011 - Rétinographie Couleur

Un jour après vitrectomie, le retrait du tissu fibrovasculaire et photocoagulation au laser

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

Fundus photograph 2 weeks after vitreoretinal surgery

8ème évaluation

5 0

18 11 2011 - Rétinographie Couleur

Un mois après la chirurgie

Hémorragie vitréenne. La chirurgie vitréorétinienne est recommandée

Fundus photograph showing vitreous hemorrhage. We recommended vitreoretinal surgery

18 11 2011 - Tonométrie

9ème évaluation - postopératoire

16 0

25 11 2011 - Autofluorescence

25 11 2011 - Infrarouge

25 11 2011 - OCT B-Scan (Longitudinal)

25 11 2011 - Photographie du Segment Antérieur

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

25 11 2011 - Red-free

25 11 2011 - Rétinographie Couleur

Un jour après vitrectomie, le retrait du tissu fibrovasculaire et photocoagulation au laser

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

10ème évaluation

20 0

24 01 2012 - Autofluorescence

24 01 2012 - Infrarouge

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 - Photographie du Segment Antérieur

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

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

24 01 2012 - Red-free

24 01 2012 - Rétinographie Couleur

3 mois après la chirurgie vitréorétinienne. AV: 20/40 OD

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

11ème évaluation

8 0

06 02 2013 - OCT B-Scan (Longitudinal)

HbA1c: 7.9 %. AV: 20/50 OD; 20/60 OG

06 02 2013 - Rétinographie Couleur

Ultra-widefield photograph

Ultra-widefield photograph

12ème évaluation

8 0

01 04 2014 - OCT B-Scan (Longitudinal)

AV cc: 20/50 OU

01 04 2014 - Rétinographie Couleur

Centro Cirúrgico de Coimbra

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Centro Cirúrgico de Coimbra

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