Derniers ajouts - Vitreous Hemorrhage - Mild 58-year-old woman has diabetic retinopathy in both eyes with neovascularization of the optic nerve, worse in the right eye than the left eye. She has had panretinal laser in both eyes and vitreous hemorrhage in the left eye. Her vision, since I saw her last in June, is about the same.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/20. IOP: OD 16, OS 17. There is trace nuclear sclerosis in both eyes.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.1. There is a large tuft of neovascularization on the superior pole of the optic nerve, extending about 2-3 disc diameters off the nerve. There is tractional retinal detachment superotemporal to the periphery. There is moderate panretinal laser.
OS: Vertical C/D ratio is 0.0. There is an area of neovascularization on the inferior pole of the optic nerve, as well as in the inferotemporal periphery.
PHOTOGRAPHS: Photos confirm clinical findings.
FLUORESCEIN ANGIOGRAPHY: FA shows excellent perfusion of each eye with areas of hypofluorescence corresponding to the hemorrhage and hyperfluorescence corresponding to the microaneurysms. There is also leakage from neovascularization on the nerve in each eye in the late frames, more in the right eye than the left eye.
IMPRESSION: 1. PROLIFERATIVE DIABETIC RETINOPATHY – BOTH EYES
2. HIGH-RISK DIABETIC RETINOPATHY – BOTH EYES
3. VITREOUS HEMORRHAGE – LEFT EYE
4. PREVIOUS LASER
DISCUSSION: I explained to the patient with further panretinal laser there is an excellent chance of inducing regression of the neovascularization and controlling her diabetic retinopathy. I gave the right eye retrobulbar anesthetic injection today and I added the laser to the periphery. I asked her to return for check in about three to four weeks for similar treatment in the left eye.
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PDR - Preretinal Fibrosisvu 834 fois58-year-old woman has diabetic retinopathy in both eyes with neovascularization of the optic nerve, worse in the right eye than the left eye. She has had panretinal laser in both eyes and vitreous hemorrhage in the left eye. Her vision, since I saw her last in June, is about the same.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/20. 27 Octobre 2010
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PDR - NVEvu 680 fois58-year-old woman has diabetic retinopathy in both eyes with neovascularization of the optic nerve, worse in the right eye than the left eye. She has had panretinal laser in both eyes and vitreous hemorrhage in the left eye. Her vision, since I saw her last in June, is about the same.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/20. 27 Octobre 2010
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PDR - Macula Line Scanvu 494 fois58-year-old woman has diabetic retinopathy in both eyes with neovascularization of the optic nerve, worse in the right eye than the left eye. She has had panretinal laser in both eyes and vitreous hemorrhage in the left eye. Her vision, since I saw her last in June, is about the same.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/20. 27 Octobre 2010
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PDRvu 471 fois58-year-old woman has diabetic retinopathy in both eyes with neovascularization of the optic nerve, worse in the right eye than the left eye. She has had panretinal laser in both eyes and vitreous hemorrhage in the left eye. Her vision, since I saw her last in June, is about the same.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/20. 27 Octobre 2010
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PDRvu 460 fois58-year-old woman has diabetic retinopathy in both eyes with neovascularization of the optic nerve, worse in the right eye than the left eye. She has had panretinal laser in both eyes and vitreous hemorrhage in the left eye. Her vision, since I saw her last in June, is about the same.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/20. 27 Octobre 2010
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PDRvu 465 fois58-year-old woman has diabetic retinopathy in both eyes with neovascularization of the optic nerve, worse in the right eye than the left eye. She has had panretinal laser in both eyes and vitreous hemorrhage in the left eye. Her vision, since I saw her last in June, is about the same.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/20. 27 Octobre 2010
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PDR - Mild Vitreous Hemorrhage and Good Visionvu 487 fois58-year-old woman has diabetic retinopathy in both eyes with neovascularization of the optic nerve, worse in the right eye than the left eye. She has had panretinal laser in both eyes and vitreous hemorrhage in the left eye. Her vision, since I saw her last in June, is about the same.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/20. 27 Octobre 2010
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PDR - Mild Vitreous Hemorrhage and Good Visionvu 486 fois58-year-old woman has diabetic retinopathy in both eyes with neovascularization of the optic nerve, worse in the right eye than the left eye. She has had panretinal laser in both eyes and vitreous hemorrhage in the left eye. Her vision, since I saw her last in June, is about the same.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/20. 27 Octobre 2010
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PDR - Mild Vitreous Hemorrhage and Good Visionvu 480 fois58-year-old woman has diabetic retinopathy in both eyes with neovascularization of the optic nerve, worse in the right eye than the left eye. She has had panretinal laser in both eyes and vitreous hemorrhage in the left eye. Her vision, since I saw her last in June, is about the same.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/20. 27 Octobre 2010
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PDR - Mild Vitreous Hemorrhage and Good Visionvu 427 fois58-year-old woman has diabetic retinopathy in both eyes with neovascularization of the optic nerve, worse in the right eye than the left eye. She has had panretinal laser in both eyes and vitreous hemorrhage in the left eye. Her vision, since I saw her last in June, is about the same.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/20. 27 Octobre 2010
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PDR - Mild Vitreous Hemorrhage and Good Visionvu 461 fois58-year-old woman has diabetic retinopathy in both eyes with neovascularization of the optic nerve, worse in the right eye than the left eye. She has had panretinal laser in both eyes and vitreous hemorrhage in the left eye. Her vision, since I saw her last in June, is about the same.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/20. 27 Octobre 2010
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PDR - Mild Vitreous Hemorrhage and Good Visionvu 442 fois58-year-old woman has diabetic retinopathy in both eyes with neovascularization of the optic nerve, worse in the right eye than the left eye. She has had panretinal laser in both eyes and vitreous hemorrhage in the left eye. Her vision, since I saw her last in June, is about the same.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/20. 27 Octobre 2010
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PDR - Mild Vitreous Hemorrhage and Good Visionvu 468 fois58-year-old woman has diabetic retinopathy in both eyes with neovascularization of the optic nerve, worse in the right eye than the left eye. She has had panretinal laser in both eyes and vitreous hemorrhage in the left eye. Her vision, since I saw her last in June, is about the same.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/20. 27 Octobre 2010
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PDR - Mild Vitreous Hemorrhage and Good Visionvu 434 fois58-year-old woman has diabetic retinopathy in both eyes with neovascularization of the optic nerve, worse in the right eye than the left eye. She has had panretinal laser in both eyes and vitreous hemorrhage in the left eye. Her vision, since I saw her last in June, is about the same.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/20. 27 Octobre 2010
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PDR - Mild Vitreous Hemorrhage and Good Visionvu 435 fois58-year-old woman has diabetic retinopathy in both eyes with neovascularization of the optic nerve, worse in the right eye than the left eye. She has had panretinal laser in both eyes and vitreous hemorrhage in the left eye. Her vision, since I saw her last in June, is about the same.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/20. 27 Octobre 2010
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PDR - Mild Vitreous Hemorrhage and Good Visionvu 457 fois58-year-old woman has diabetic retinopathy in both eyes with neovascularization of the optic nerve, worse in the right eye than the left eye. She has had panretinal laser in both eyes and vitreous hemorrhage in the left eye. Her vision, since I saw her last in June, is about the same.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/20. 27 Octobre 2010
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PDR - Mild Vitreous Hemorrhage and Good Visionvu 448 fois58-year-old woman has diabetic retinopathy in both eyes with neovascularization of the optic nerve, worse in the right eye than the left eye. She has had panretinal laser in both eyes and vitreous hemorrhage in the left eye. Her vision, since I saw her last in June, is about the same.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/20. 27 Octobre 2010
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PDR - Mild Vitreous Hemorrhage and Good Visionvu 465 fois58-year-old woman has diabetic retinopathy in both eyes with neovascularization of the optic nerve, worse in the right eye than the left eye. She has had panretinal laser in both eyes and vitreous hemorrhage in the left eye. Her vision, since I saw her last in June, is about the same.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/20. 27 Octobre 2010
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PDR - Mild Vitreous Hemorrhage and Good Visionvu 480 fois58-year-old woman has diabetic retinopathy in both eyes with neovascularization of the optic nerve, worse in the right eye than the left eye. She has had panretinal laser in both eyes and vitreous hemorrhage in the left eye. Her vision, since I saw her last in June, is about the same.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/20. 27 Octobre 2010
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PDR - Mild Vitreous Hemorrhage and Good Visionvu 504 fois58-year-old woman has diabetic retinopathy in both eyes with neovascularization of the optic nerve, worse in the right eye than the left eye. She has had panretinal laser in both eyes and vitreous hemorrhage in the left eye. Her vision, since I saw her last in June, is about the same.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/20. 27 Octobre 2010
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PDR - Mild Vitreous Hemorrhage and Good Visionvu 631 fois58-year-old woman has diabetic retinopathy in both eyes with neovascularization of the optic nerve, worse in the right eye than the left eye. She has had panretinal laser in both eyes and vitreous hemorrhage in the left eye. Her vision, since I saw her last in June, is about the same.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/20. 27 Octobre 2010
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PDR - Mild Vitreous Hemorrhage and Good Visionvu 550 fois58-year-old woman has diabetic retinopathy in both eyes with neovascularization of the optic nerve, worse in the right eye than the left eye. She has had panretinal laser in both eyes and vitreous hemorrhage in the left eye. Her vision, since I saw her last in June, is about the same.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/20. 27 Octobre 2010
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PDR - Mild Vitreous Hemorrhage and Good Visionvu 557 fois58-year-old woman has diabetic retinopathy in both eyes with neovascularization of the optic nerve, worse in the right eye than the left eye. She has had panretinal laser in both eyes and vitreous hemorrhage in the left eye. Her vision, since I saw her last in June, is about the same.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/20. 27 Octobre 2010
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PDR - Mild Vitreous Hemorrhage and Good Visionvu 607 fois58-year-old woman has diabetic retinopathy in both eyes with neovascularization of the optic nerve, worse in the right eye than the left eye. She has had panretinal laser in both eyes and vitreous hemorrhage in the left eye. Her vision, since I saw her last in June, is about the same.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/20. 27 Octobre 2010
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PDR - Mild Vitreous Hemorrhage and Good Visionvu 682 fois58-year-old woman has diabetic retinopathy in both eyes with neovascularization of the optic nerve, worse in the right eye than the left eye. She has had panretinal laser in both eyes and vitreous hemorrhage in the left eye. Her vision, since I saw her last in June, is about the same.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/20. 27 Octobre 2010
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PDR - Mild Vitreous Hemorrhage and Good Visionvu 471 fois58-year-old woman has diabetic retinopathy in both eyes with neovascularization of the optic nerve, worse in the right eye than the left eye. She has had panretinal laser in both eyes and vitreous hemorrhage in the left eye. Her vision, since I saw her last in June, is about the same.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/20. 27 Octobre 2010
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PDR - Mild Vitreous Hemorrhage and Good Visionvu 466 fois58-year-old woman has diabetic retinopathy in both eyes with neovascularization of the optic nerve, worse in the right eye than the left eye. She has had panretinal laser in both eyes and vitreous hemorrhage in the left eye. Her vision, since I saw her last in June, is about the same.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/20. 27 Octobre 2010
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58-year-old woman has diabetic retinopathy in both eyes with neovascularization of the optic nerve, worse in the right eye than the left eye. She has had panretinal laser in both eyes and vitreous hemorrhage in the left eye. Her vision, since I saw her last in June, is about the same.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/20. IOP: OD 16, OS 17. There is trace nuclear sclerosis in both eyes.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.1. There is a large tuft of neovascularization on the superior pole of the optic nerve, extending about 2-3 disc diameters off the nerve. There is tractional retinal detachment superotemporal to the periphery. There is moderate panretinal laser.
OS: Vertical C/D ratio is 0.0. There is an area of neovascularization on the inferior pole of the optic nerve, as well as in the inferotemporal periphery.
PHOTOGRAPHS: Photos confirm clinical findings.
FLUORESCEIN ANGIOGRAPHY: FA shows excellent perfusion of each eye with areas of hypofluorescence corresponding to the hemorrhage and hyperfluorescence corresponding to the microaneurysms. There is also leakage from neovascularization on the nerve in each eye in the late frames, more in the right eye than the left eye.
IMPRESSION: 1. PROLIFERATIVE DIABETIC RETINOPATHY – BOTH EYES
2. HIGH-RISK DIABETIC RETINOPATHY – BOTH EYES
3. VITREOUS HEMORRHAGE – LEFT EYE
4. PREVIOUS LASER
DISCUSSION: I explained to the patient with further panretinal laser there is an excellent chance of inducing regression of the neovascularization and controlling her diabetic retinopathy. I gave the right eye retrobulbar anesthetic injection today and I added the laser to the periphery. I asked her to return for check in about three to four weeks for similar treatment in the left eye.
