Retinal Assistant Module Blog

Sixty-four-year-old pseudophakic known to be diabetic had a history of steroid-induced glaucoma and successfully treated for endophthalmitis with intravitreal antibiotics due to intravitreal Bevacizumab. His vision is counting fingers with central diabetic macular edema managed with Hybridthrehold laser (HT laser). After 24 weeks, there is a reduction of central macular thickening and improved vision up to 20/40 OCT cross-sections before and after treatment with HT laser Disclosure HT laser parameters developed by Ameen Marashi. Please check the  Clinical guidelines for Diabetic retinopathy

This case is an example of RPE atrophy induced by focal laser photocoagulation. Fundus Image Fundus exam showed non-proliferative diabetic retinopathy along with hard exudates, central diabetic macular edema, intraretinal blood, and patches of RPE atrophy as a result of previous laser treatment. Fundus image shows diabetic macular edema with focal atrophy post focal laser treatment Optical coherence tomography OCT scan shows increased central retinal thickness, with the cystic formation in the inner retinal tissues with hyperreflective foci presenting hard exudates and RPE atrophy induced by laser photocoagulation treatment. OCT cross-section showing centra DME with non-central RPE atrophy Discussion This patient has good BCVA 20/32 despite RPE atrophy's presence because of its location away from FAZ. This patient was managed as central DME with monthly intravitreal injection of AntiVEGF. Please check  clinical guidelines in diabetic retinopathy

A 51 years old male known to be diabetic for ten years with excellent glycemic control profile along with normal blood pressure presented with BCVA 20/100 in his left eye; he had a better vision of 20/30 in the same eye one year ago when he used to be on intravitreal injections of aflibercept, but he decided to discontinue intravitreal injection as been advised by another physician. Fundus image His fundus image shows cystic formation at the fovea with a sign of intraretinal dot and blots hemorrhages in the mid periphery with cotton wool spots and IRMA (Intra Retinal Microvascular Abnormalities). Fundus image showing macular edema with intraretinal hemorrhage and cotton wool spots Optical coherence tomography His OCT scan shows thickened central macular tissues with disorganization of inner retinal layers and non-empty cystic formation as it is classic findings of diabetic macular edema with some empty cystic formation; however, the ellipsoid zone looks intact. OCT cross-section for ce...