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74-year-old man has a macular pucker in the left eye. He also has diabetic retinopathy. His left eye was last lasered in 2005. When he was here last, the macula was more swollen and I suggested he come back for an evaluation. If anything, his vision is pretty good today. His hemoglobin A1Cs were high last time and now they are better. Today it is 7.0. VISUAL ACUITY: Vision OD is 20/25, OS is 20/40. IOP: 12 in both eyes. The posterior chamber intraocular lens is in good position in both eyes with open capsules. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.3. There are rare retinal hemorrhages. OS: Vertical C/D ratio is 0.3. There is a macular pucker inferotemporal to the fovea. There are rare retinal hemorrhages. PHOTOGRAPHS: Photos confirm clinical findings. FLUORESCEIN ANGIOGRAM: FA shows diffuse leakage in the area of the macular pucker, which is inferotemporal to the fovea. There are multiple microaneurysms in both eyes which leak some in the late frames; however, in the area of heavy leakage under the macular pucker, there are very few microaneurysms. IMPRESSION: 1. DIABETIC RETINOPATHY – BOTH EYES 2. MACULAR PUCKER – LEFT EYE 3. MACULAR EDEMA – LEFT EYE DISCUSSION: I explained to the patient there is edema around the macular pucker, which looks to be tractional. Given that his vision is reasonable at 20/40, which is not particularly worse than it was six years ago, I suggested that we leave the eye alone. I did ask him to return for check in six months, sooner should he notice a problem.

macpuckerbdr_scje01.jpg
Macular Pucker - Diabetic - Severe non-foveal Edema OS152 views74-year-old man has a macular pucker in the left eye and diabetic retinopathy.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/40.
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(0 votes)
macpuckerbdr_scje02.jpg
Macular Pucker - Diabetic - Severe non-foveal Edema OS81 views74-year-old man has a macular pucker in the left eye and diabetic retinopathy.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/40.
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(0 votes)
macpuckerbdr_scje03.jpg
Macular Pucker - Diabetic - Severe non-foveal Edema OS140 views74-year-old man has a macular pucker in the left eye and diabetic retinopathy.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/40.
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(0 votes)
macpuckerbdr_scje04.jpg
Macular Pucker - Diabetic - Severe non-foveal Edema OS147 views33333
(1 votes)
macpuckerbdr_scje05.jpg
Macular Pucker - Diabetic - Severe non-foveal Edema OS83 views74-year-old man has a macular pucker in the left eye and diabetic retinopathy.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/40.
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(0 votes)
macpuckerbdr_scje06.jpg
Macular Pucker - Diabetic - Severe non-foveal Edema OS80 views74-year-old man has a macular pucker in the left eye and diabetic retinopathy.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/40.
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(0 votes)
macpuckerbdr_scje07.jpg
Macular Pucker - Diabetic - Severe non-foveal Edema OS82 views74-year-old man has a macular pucker in the left eye and diabetic retinopathy.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/40.
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(0 votes)
macpuckerbdr_scje08.jpg
Macular Pucker - Diabetic - Severe non-foveal Edema OS83 views74-year-old man has a macular pucker in the left eye and diabetic retinopathy.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/40.
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(0 votes)
macpuckerbdr_scje09.jpg
Macular Pucker - Diabetic - Severe non-foveal Edema OS53 views74-year-old man has a macular pucker in the left eye and diabetic retinopathy.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/40.
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(0 votes)
macpuckerbdr_scje10.jpg
Macular Pucker - Diabetic - Severe non-foveal Edema OS104 views74-year-old man has a macular pucker in the left eye and diabetic retinopathy.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/40.
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(0 votes)
macpuckerbdr_scje11.jpg
Macular Pucker - Diabetic - Severe non-foveal Edema OS115 views74-year-old man has a macular pucker in the left eye and diabetic retinopathy.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/40.
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(0 votes)
macpuckerbdr_scje12.jpg
Macular Pucker - Diabetic - Severe non-foveal Edema OS139 views74-year-old man has a macular pucker in the left eye and diabetic retinopathy.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/40.
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(0 votes)
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74-year-old man has a macular pucker in the left eye. He also has diabetic retinopathy. His left eye was last lasered in 2005. When he was here last, the macula was more swollen and I suggested he come back for an evaluation. If anything, his vision is pretty good today. His hemoglobin A1Cs were high last time and now they are better. Today it is 7.0. VISUAL ACUITY: Vision OD is 20/25, OS is 20/40. IOP: 12 in both eyes. The posterior chamber intraocular lens is in good position in both eyes with open capsules. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.3. There are rare retinal hemorrhages. OS: Vertical C/D ratio is 0.3. There is a macular pucker inferotemporal to the fovea. There are rare retinal hemorrhages. PHOTOGRAPHS: Photos confirm clinical findings. FLUORESCEIN ANGIOGRAM: FA shows diffuse leakage in the area of the macular pucker, which is inferotemporal to the fovea. There are multiple microaneurysms in both eyes which leak some in the late frames; however, in the area of heavy leakage under the macular pucker, there are very few microaneurysms. IMPRESSION: 1. DIABETIC RETINOPATHY – BOTH EYES 2. MACULAR PUCKER – LEFT EYE 3. MACULAR EDEMA – LEFT EYE DISCUSSION: I explained to the patient there is edema around the macular pucker, which looks to be tractional. Given that his vision is reasonable at 20/40, which is not particularly worse than it was six years ago, I suggested that we leave the eye alone. I did ask him to return for check in six months, sooner should he notice a problem.