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Last additions - NVD - Neovascularization of the Disc - Macular Edema

57-year-old man has diabetic retinopathy in both eyes. Diabetic for 14 years with HgB A1C often over 10. VISUAL ACUITY: OD 20/30, OS 20/40. IOP: OD 11, OS 12. The right eye has a posterior chamber intraocular lens in good position. The left eye has 1+ nuclear sclerosis. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.1. There are multiple microaneurysms and light laser and patchy hemorrhages. There is also exudate inferotemporal to the fovea. OS: Vertical C/D ratio is 0.0. There is neovascularization on the nerve extending about a disc and a half diameter off the nerve. There is also patchy microaneurysms and light laser. OCT SCAN: The OCT scan of the right eye shows a normal central foveal thickness. The left eye however, does show macular edema centrally. Photos confirm clinical findings. FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows leaking microaneurysms in each eye, as well as leakage from the neovascularization in the left eye. IMPRESSION: 1. PROLIFERATIVE DIABETIC RETINOPATHY – LEFT EYE 2. CLINICALLY SIGNIFICANT MACULAR EDEMA – LEFT EYE 3. BACKGROUND DIABETIC RETINOPATHY – RIGHT EYE DISCUSSION: I explained to the patient that unfortunately the macula in the left eye has edema affecting the center of the fovea. I treated that eye with laser to try and control the edema and prevent further vision loss and possibly improve the vision. In addition, because of the proliferative diabetic retinopathy, the left eye needs to start pan retinal laser. I would like to allow the focal laser to take affect though and therefore I am going to have him return in about a month for evaluation and probable further laser

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PDR OS with NVE777 views57-year-old man has diabetic retinopathy in both eyes.
Diabetic for 14 years with HgB A1C often over 10.
VISUAL ACUITY: OD 20/30, OS 20/40. PDR OS BDR OD
Oct 27, 2010
pdr_nve_51677_282829.png
BDR OD with Edema642 views57-year-old man has diabetic retinopathy in both eyes.
Diabetic for 14 years with HgB A1C often over 10.
VISUAL ACUITY: OD 20/30, OS 20/40. PDR OS BDR OD
Oct 27, 2010
pdr_nve_51677_282729.png
BDR OD with Edema656 views57-year-old man has diabetic retinopathy in both eyes.
Diabetic for 14 years with HgB A1C often over 10.
VISUAL ACUITY: OD 20/30, OS 20/40. PDR OS BDR OD
Oct 27, 2010
pdr_nve_51677_282129.png
BDR OD with Edema368 views57-year-old man has diabetic retinopathy in both eyes.
Diabetic for 14 years with HgB A1C often over 10.
VISUAL ACUITY: OD 20/30, OS 20/40. PDR OS BDR OD
Oct 27, 2010
pdr_nve_51677_281929.png
PDR OS with NVE379 views57-year-old man has diabetic retinopathy in both eyes.
Diabetic for 14 years with HgB A1C often over 10.
VISUAL ACUITY: OD 20/30, OS 20/40. PDR OS BDR OD
Oct 27, 2010
pdr_nve_51677_281829.png
BDR OD with Edema376 views57-year-old man has diabetic retinopathy in both eyes.
Diabetic for 14 years with HgB A1C often over 10.
VISUAL ACUITY: OD 20/30, OS 20/40. PDR OS BDR OD
Oct 27, 2010
pdr_nve_51677_281729.png
PDR OS with NVE377 views57-year-old man has diabetic retinopathy in both eyes.
Diabetic for 14 years with HgB A1C often over 10.
VISUAL ACUITY: OD 20/30, OS 20/40. PDR OS BDR OD
Oct 27, 2010
pdr_nve_51677_281629.png
BDR OD with Edema392 views57-year-old man has diabetic retinopathy in both eyes.
Diabetic for 14 years with HgB A1C often over 10.
VISUAL ACUITY: OD 20/30, OS 20/40. PDR OS BDR OD
Oct 27, 2010
pdr_nve_51677_281329.png
PDR OS with NVE342 views57-year-old man has diabetic retinopathy in both eyes.
Diabetic for 14 years with HgB A1C often over 10.
VISUAL ACUITY: OD 20/30, OS 20/40. PDR OS BDR OD
Oct 27, 2010
pdr_nve_51677_281029.png
PDR OS with NVE393 views57-year-old man has diabetic retinopathy in both eyes.
Diabetic for 14 years with HgB A1C often over 10.
VISUAL ACUITY: OD 20/30, OS 20/40. PDR OS BDR OD
Oct 27, 2010
pdr_nve_51677_28929.png
PDR OS with NVE378 views57-year-old man has diabetic retinopathy in both eyes.
Diabetic for 14 years with HgB A1C often over 10.
VISUAL ACUITY: OD 20/30, OS 20/40. PDR OS BDR OD
Oct 27, 2010
pdr_nve_51677_28829.png
PDR OS with NVE382 views57-year-old man has diabetic retinopathy in both eyes.
Diabetic for 14 years with HgB A1C often over 10.
VISUAL ACUITY: OD 20/30, OS 20/40. PDR OS BDR OD
Oct 27, 2010
pdr_nve_51677_28729.png
PDR OS with NVE431 views57-year-old man has diabetic retinopathy in both eyes.
Diabetic for 14 years with HgB A1C often over 10.
VISUAL ACUITY: OD 20/30, OS 20/40. PDR OS BDR OD
Oct 27, 2010
pdr_nve_51677_28629.png
BDR OD with Edema396 views57-year-old man has diabetic retinopathy in both eyes.
Diabetic for 14 years with HgB A1C often over 10.
VISUAL ACUITY: OD 20/30, OS 20/40. PDR OS BDR OD
Oct 27, 2010
pdr_nve_51677_28529.png
PDR OS with NVE506 views57-year-old man has diabetic retinopathy in both eyes.
Diabetic for 14 years with HgB A1C often over 10.
VISUAL ACUITY: OD 20/30, OS 20/40. PDR OS BDR OD
Oct 27, 2010
pdr_nve_51677_28329.png
BDR OD with Edema549 views57-year-old man has diabetic retinopathy in both eyes.
Diabetic for 14 years with HgB A1C often over 10.
VISUAL ACUITY: OD 20/30, OS 20/40. PDR OS BDR OD
Oct 27, 2010
pdr_nve_51677_28129.jpg
PDR OS with NVE1130 views57-year-old man has diabetic retinopathy in both eyes.
Diabetic for 14 years with HgB A1C often over 10.
VISUAL ACUITY: OD 20/30, OS 20/40. PDR OS BDR OD
Oct 27, 2010
pdr_nve_51677.png
PDR OS with NVE1264 views57-year-old man has diabetic retinopathy in both eyes.
Diabetic for 14 years with HgB A1C often over 10.
VISUAL ACUITY: OD 20/30, OS 20/40. PDR OS BDR OD
Oct 27, 2010
   
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57-year-old man has diabetic retinopathy in both eyes. Diabetic for 14 years with HgB A1C often over 10. VISUAL ACUITY: OD 20/30, OS 20/40. IOP: OD 11, OS 12. The right eye has a posterior chamber intraocular lens in good position. The left eye has 1+ nuclear sclerosis. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.1. There are multiple microaneurysms and light laser and patchy hemorrhages. There is also exudate inferotemporal to the fovea. OS: Vertical C/D ratio is 0.0. There is neovascularization on the nerve extending about a disc and a half diameter off the nerve. There is also patchy microaneurysms and light laser. OCT SCAN: The OCT scan of the right eye shows a normal central foveal thickness. The left eye however, does show macular edema centrally. Photos confirm clinical findings. FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows leaking microaneurysms in each eye, as well as leakage from the neovascularization in the left eye. IMPRESSION: 1. PROLIFERATIVE DIABETIC RETINOPATHY – LEFT EYE 2. CLINICALLY SIGNIFICANT MACULAR EDEMA – LEFT EYE 3. BACKGROUND DIABETIC RETINOPATHY – RIGHT EYE DISCUSSION: I explained to the patient that unfortunately the macula in the left eye has edema affecting the center of the fovea. I treated that eye with laser to try and control the edema and prevent further vision loss and possibly improve the vision. In addition, because of the proliferative diabetic retinopathy, the left eye needs to start pan retinal laser. I would like to allow the focal laser to take affect though and therefore I am going to have him return in about a month for evaluation and probable further laser