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RETINAL VASCULAR DISEASES

Cotton-Wool Spots

Clinical Case 01

Cotton-Wool Spots - Clinical Case 01

Fundus photograph in a 53-year-old female patient with diabetes diagnosed 5 years ago, showing cotton-wool spots and microaneurysms. HbA1c=6,4%. Visual acuity: 20/20 OU after cataract surgery

Cotton-Wool Spots - Clinical Case 01

Fundus photograph, 8 months later. HbA1c=6,4%

Evaluations

1st evaluation

24 0

12 07 2010 - Anterior Segment Photo

Anterior segment photograph (RE) in a 53-year-old female patient with diabetes diagnosed 5 years ago. HbA1c=11,4%. Visual acuity: 20/40 OU

Anterior segment photograph (LE) in a 53-year-old female patient with diabetes diagnosed 5 years ago. HbA1c=11,4%. Visual acuity: 20/40 OU

Anterior segment photograph after pupil dilation showing nuclear and posterior subcapsular cataract at right eye

Anterior segment photograph after pupil dilation showing nuclear and posterior subcapsular cataract at left eye

12 07 2010 - Autofluorescence

12 07 2010 - Colour Retinography

Ultra-widefield photograph shows the shadow of cataract on the retinal fundus. HbA1c=11,4%

Ultra-widefield shows the shadow of cataract on the retinal fundus. HbA1c=11,4%

12 07 2010 - Echography

A-scan echogram of right eye

12 07 2010 - Infrared

12 07 2010 - Microperimetry

12 07 2010 - OCT B-Scan (Longitudinal)

12 07 2010 - Red-free

12 07 2010 - Tonometry

2nd evaluation - preoperative

11 0

25 11 2010 - Anterior Segment Photo

Anterior segment photograph of right eye showing cataract before surgery. HgA1c=6,2%

Anterior segment photograph before cataract surgery, showing no evidence of blepharitis at right eye

Anterior segment photograph before cataract surgery shows no evidence of blepharitis at right eye

Anterior segment photograph before cataract surgery, showing no evidence of blepharitis at left eye

Anterior segment photograph of left eye one day after surgery

15 02 2011 - Tonometry

3rd evaluation

26 0

13 06 2011 - Autofluorescence

Fundus autofluorescence, with hipoautofluorescent areas, corresponding to blockage by the cotton-wool spots and ischemic retinal area superior to the fovea

Fundus autofluorescence, with hipoautofluorescent areas, corresponding to blockage by intra-retinal hemorrhages and cotton-wool spots

13 06 2011 - Colour Retinography

Fundus photograph showing cotton-wool spots and microaneurysms. HgA1c=6,4%. Visual acuity: 20/20 OU after cataract surgery

Fundus photograph showing cotton-wool spots, microaneurysms and retinal hemorrhage. HgA1c= 6,4%. Visual acuity: 20/20 OU after cataract surgery

13 06 2011 - Fluorescein Angiography

Fluorescein angiogram at early phase showing an extensive ischaemic justafoveolar area

Fluorescein angiogram at early phase showing an extensive ischaemic justafoveolar area

Fluorescein angiogram at early phase showing an extensive ischaemic justafoveolar area

Fluorescein angiogram showing several ischemic areas, microaneurysms and leakage at left eye

Fluorescein angiogram at mid-phase showing an extensive ischaemic justafoveolar area

Fluorescein angiogram at mid-phase, showing multiple points of exsudation

Fluorescein angiogram at mid-phase, showing multiple points of exsudation

Fluorescein angiogram at late phase, showing multiple points of exsudation

Fluorescein angiogram at late phase showing an extensive justafoveolar ischemic area

Fluorescein angiogram at late phase showing some areas of ischemia

13 06 2011 - Infrared

13 06 2011 - OCT B-Scan (Longitudinal)

OCT line-scan showing no foveal edema

OCT line-scan showing no foveal edema

OCT line-scan showing no foveal edema

OCT line-scan showing no foveal edema

OCT line-scan showing no foveal edema

OCT line-scan showing multiple hyperreflective intraretinal deposits corresponding to hard exsudates

OCT line-scan showing no foveal edema

13 06 2011 - Red-free

4th evaluation

34 0

14 07 2011 - Autofluorescence

Fundus autofluorescence showing, areas of hypoautofluorescence due to blockage by intra-retinal hemorrhages

Fundus autofluorescence showing, areas of hypoautofluorescence due to blockage by intra-retinal hemorrhages

14 07 2011 - Colour Retinography

Fundus photograph showing cotton-wool spots and microaneurysms. HgA1c=6,4%

Fundus photograph showing cotton-wool spots and microaneurysms. HgA1c=6,4%

Fundus photograph showing multiple peri-papilary neovascular foci

Fundus photograph showing peri-papilar neovascularization

14 07 2011 - Infrared

14 07 2011 - Microperimetry

14 07 2011 - Nervous Fiber Analysis

14 07 2011 - OCT B-Scan (Longitudinal)

OCT line-scan showing attached posterior hyaloid

OCT line-scan showing attached posterior hyaloid

OCT line-scan showing macular edema

14 07 2011 - Perimetry

14 07 2011 - Red-free

14 07 2011 - Tonometry

5th evaluation

36 0

20 09 2011 - Autofluorescence

20 09 2011 - Colour Retinography

Fundus photograph showing reduction of cotton-wool spots. HgA1c=7,7%

Fundus photograph showing a cotton-wool spot, microaneurysms, some retinal hemorrhages and exudates. HgA1c=7,7%

Fundus photograph, notice the neovessels

Fundus photograph, notice the neovessels

20 09 2011 - Infrared

20 09 2011 - OCT B-Scan (Longitudinal)

CT line-scan showing attached taut posterior hyaloid

CT line-scan showing attached taut posterior hyaloid

CT line-scan showing attached taut posterior hyaloid

20 09 2011 - Red-free

20 09 2011 - Tonometry

6th evaluation

20 0

24 01 2012 - Anterior Segment Photo

24 01 2012 - Fluorescein Angiography

Fluorescein angiogram at arterial phase

Fluorescein angiogram at early phase showing visible signs of proliferative diabetic retinopathy; notice the capillary dropout, as well as the irregular contour and increased diameter of the foveal avascular zone

Fluorescein angiogram at early phase showing visible signs of proliferative diabetic retinopathy; notice the neovascularization inferior to the optic disc, the cappilary dropout, as well as the irregular contour and increased diameter of the foveal avascular zone

Fluorescein angiogram at early phase showing visible signs of proliferative diabetic retinopathy; notice the neovascularization inferior to the optic disc, the capillary dropout, as well as the irregular contour and increased diameter of the foveal avascular zone

Fluorescein angiogram at mid-phase showing multiple microaneurysms, cappilary dropout and neovascularization inferior to the optic disc

Fluorescein angiogram at mid-phase showing leakage near the optic disc

Fluorescein angiogram at mid-phase showing leakage near the optic disc

7th evaluation

17 0

02 02 2012 - Autofluorescence

02 02 2012 - Colour Retinography

Ultra-widefield photograph after laser therapy

Ultra-widefield photograph after laser therapy

02 02 2012 - Infrared

02 02 2012 - OCT B-Scan (Longitudinal)

02 02 2012 - Red-free

02 02 2012 - Tonometry

Centro Cirúrgico de Coimbra

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