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Most viewed - Diabetic Macular Edema - Good Vision 63-year-old man was seen in the office on May 10, 2012. He has been diabetic for twenty two years. You have been seeing him regularly lately. He did have a stroke in September. He lost his right peripheral vision. That is coming back some and you noticed problems with the macula and suggest he come here for an evaluation. His central vision is fine. VISUAL ACUITY: OD 20/25, OS 20/25. IOP: OD 11, OS 14. SLIT EXAMINATION: There is 2+ nuclear sclerosis in both eyes. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.6. There is no posterior vitreous separation. There is exudate and microaneurysms clustered particularly inferior to the fovea. OS: Vertical C/D ratio is 0.6. There is no posterior vitreous separation. There is exudate and microaneurysms clustered superior to the fovea. In both eyes there does appear to be edema within 500 microns of the center of the fovea. SPECTRALIS-SD-OCT SCAN: The OCT scan in the right eye shows an average central foveal thickness of 270 microns, which is normal. The left eye shows an average central foveal thickness of 258 microns, which is normal. Both eyes though do have edema within less than a disc-diameter in the center. FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows microaneurysms leaking inferior to the fovea in the right eye and superior to the fovea in the left eye. FUNDUS PHOTOGRAPHY - INFRA RED: The infra red and auto fluorescence images show a cluster of microaneurysms inferior to the fovea with some hemorrhage in that area. The infra red and auto fluorescence images in the left eye show microaneurysms clustered superior to the fovea with some hemorrhage in that area. IMPRESSION: 1. BACKGROUND DIABETIC RETINOPATHY – BOTH EYES 2. CLINICALLY SIGNIFICANT MACULAR EDEMA – BOTH EYES DISCUSSION: I explained to the patient he does have diabetic macular edema in both eyes. The ETDRS study shows that laser treatment is beneficial in this situation, however, the sub group analysis show that people with good vision there didn’t seem to be any difference between treated and non treated patients in two years. Therefore I think it is reasonable with today’s technology, to follow him closely and treat him should the edema worsen and not treat him should the edema stabilize or improve. To that I asked him to return for a check in three to four months or sooner should he notice a problem and see you back regularly.
Diabetic Macular Edema - Mild670 views70 year old man with mild edema did well without treatment	Diabetic Macular Edema - Mild583 views70 year old man with mild edema did well without treatment	Diabetic Macular Edema - Mild579 views70 year old man with mild edema did well without treatment	Diabetic Macular Edema - Mild559 views70 year old man with mild edema did well without treatment
Diabetic Macular Edema - Mild539 views70 year old man with mild edema did well without treatment	Diabetic Macular Edema - Mild531 views70 year old man with mild edema did well without treatment	Diabetic Macular Edema - Mild529 views70 year old man with mild edema did well without treatment	Diabetic Macular Edema - Mild525 views70 year old man with mild edema did well without treatment
Diabetic Macular Edema - Mild523 views70 year old man with mild edema did well without treatment	Diabetic Macular Edema - Mild514 views70 year old man with mild edema did well without treatment	Diabetic Macular Edema - Mild507 views70 year old man with mild edema did well without treatment	Diabetic Macular Edema - Mild502 views70 year old man with mild edema did well without treatment
Diabetic Macular Edema - Mild498 views70 year old man with mild edema did well without treatment	Diabetic Macular Edema - Mild493 views70 year old man with mild edema did well without treatment	Diabetic Macular Edema - Mild489 views70 year old man with mild edema did well without treatment	Diabetic Macular Edema - Mild486 views70 year old man with mild edema did well without treatment
Diabetic Macular Edema - Mild482 views70 year old man with mild edema did well without treatment	Diabetic Macular Edema - Mild477 views70 year old man with mild edema did well without treatment	Diabetic Macular Edema - Mild475 views70 year old man with mild edema did well without treatment	Diabetic Macular Edema - Mild474 views70 year old man with mild edema did well without treatment
Diabetic Macular Edema - Mild474 views70 year old man with mild edema did well without treatment	Diabetic Macular Edema - Mild456 views70 year old man with mild edema did well without treatment	Diabetic Macular Edema - Mild455 views70 year old man with mild edema did well without treatment	Diabetic Macular Edema - Mild453 views70 year old man with mild edema did well without treatment
Diabetic Macular Edema - Mild451 views70 year old man with mild edema did well without treatment	Diabetic Macular Edema - Mild442 views70 year old man with mild edema did well without treatment	Diabetic Macular Edema - Mild439 views70 year old man with mild edema did well without treatment
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63-year-old man was seen in the office on May 10, 2012. He has been diabetic for twenty two years. You have been seeing him regularly lately. He did have a stroke in September. He lost his right peripheral vision. That is coming back some and you noticed problems with the macula and suggest he come here for an evaluation. His central vision is fine. VISUAL ACUITY: OD 20/25, OS 20/25. IOP: OD 11, OS 14. SLIT EXAMINATION: There is 2+ nuclear sclerosis in both eyes. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.6. There is no posterior vitreous separation. There is exudate and microaneurysms clustered particularly inferior to the fovea. OS: Vertical C/D ratio is 0.6. There is no posterior vitreous separation. There is exudate and microaneurysms clustered superior to the fovea. In both eyes there does appear to be edema within 500 microns of the center of the fovea. SPECTRALIS-SD-OCT SCAN: The OCT scan in the right eye shows an average central foveal thickness of 270 microns, which is normal. The left eye shows an average central foveal thickness of 258 microns, which is normal. Both eyes though do have edema within less than a disc-diameter in the center. FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows microaneurysms leaking inferior to the fovea in the right eye and superior to the fovea in the left eye. FUNDUS PHOTOGRAPHY - INFRA RED: The infra red and auto fluorescence images show a cluster of microaneurysms inferior to the fovea with some hemorrhage in that area. The infra red and auto fluorescence images in the left eye show microaneurysms clustered superior to the fovea with some hemorrhage in that area. IMPRESSION: 1. BACKGROUND DIABETIC RETINOPATHY – BOTH EYES 2. CLINICALLY SIGNIFICANT MACULAR EDEMA – BOTH EYES DISCUSSION: I explained to the patient he does have diabetic macular edema in both eyes. The ETDRS study shows that laser treatment is beneficial in this situation, however, the sub group analysis show that people with good vision there didn’t seem to be any difference between treated and non treated patients in two years. Therefore I think it is reasonable with today’s technology, to follow him closely and treat him should the edema worsen and not treat him should the edema stabilize or improve. To that I asked him to return for a check in three to four months or sooner should he notice a problem and see you back regularly.