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Diabetic papillopathy with macular edema treated with intravitreal bevacizumab.

Al-Hinai AS, Al-Abri MS, Al-Hajri RH - Oman J Ophthalmol (2011)

Bottom Line: The right eye fundus showed only mild NPDR.The patient received an intravitreal bevacizumab injection OS followed by focal laser photocoagulation 1 month later.His optic disc swelling and the macular edema subsided rapidly after the injection and his visual acuity improved to 6/6 with disc pallor.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Sultan Qaboos University Hospital, Oman.

ABSTRACT
A 46-year-old diabetic male presented with acute painless visual loss in his left eye (OS). Visual acuity was 6/36 OS with an unremarkable anterior segment examination (OU). Posterior segment showed a swollen left optic disc with large diffuse macular edema and moderate nonproliferative diabetic retinopathy (NPDR). The right eye fundus showed only mild NPDR. Optical coherence tomography and fundus fluorescein angiography were performed which revealed left macular edema and a hyperfluorescent left optic disc. Computerized tomography scan orbit and brain was normal. The patient received an intravitreal bevacizumab injection OS followed by focal laser photocoagulation 1 month later. His optic disc swelling and the macular edema subsided rapidly after the injection and his visual acuity improved to 6/6 with disc pallor.

No MeSH data available.


Related in: MedlinePlus

OD at presentation with non-proliferative diabetic retinopathy. Thin arrows: hard exudates; Thick arrow: blot intra-retinal hemorrhage; triangle: microaneurysm
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Figure 1: OD at presentation with non-proliferative diabetic retinopathy. Thin arrows: hard exudates; Thick arrow: blot intra-retinal hemorrhage; triangle: microaneurysm

Mentions: Our case was a 46-year-old man, known to have type 2 diabetes mellitus for 10 years and hypertensive for 2 years, on oral hypoglycemic and hypotensive agents, presented to the eye clinic with painless blur of vision in his left eye (OS) of 4 days duration. His best-corrected visual acuity (BCVA) was 6/6 in the right eye (OD) and 6/36 OS with a correction of -0.75 -0.62 ×180 and +0.75 -3.25 ×70, respectively. The intraocular pressure (IOP) was 14 mm Hg in each eye (OU). The anterior segment examination was unremarkable (OU). There was mild relative afferent pupillary defect (RAPD) OS. Posterior segment examination [Figures 1 and 2] showed mild nonproliferative diabetic retinopathy without diabetic macular edema and a normal looking optic disc OD with a small cup-to-disc (CD) ratio (0.1). The OS posterior segment showed a swollen optic disc with telangiectasic vessels and a small CD ratio. There was also diffuse but not cystic, macular edema involving the papillomacular bundle with moderate NPDR. Subfoveal fluid was absent. There were no signs of proliferative disease OU. A CT scan of the brain and orbit was done and did not show any abnormalities. Optical coherent tomography (OCT) was normal OD. However, it revealed significant macular edema with a central macular thickness of 582 μm [Figures 3 and 4] OS. Fundus fluorescein angiography (FFA) OD revealed few microaneurysms, otherwise no evidence of macular or disc leakage. However, FFA OS demonstrated tremendous amount of early optic disc and macular leakage with the presence of microaneurysms, [Figures 5 and 6]. Glycosylated hemoglobin was 12.2%. A formal visual field test was not performed because of a technical reason.


Diabetic papillopathy with macular edema treated with intravitreal bevacizumab.

Al-Hinai AS, Al-Abri MS, Al-Hajri RH - Oman J Ophthalmol (2011)

OD at presentation with non-proliferative diabetic retinopathy. Thin arrows: hard exudates; Thick arrow: blot intra-retinal hemorrhage; triangle: microaneurysm
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3263167&req=5

Figure 1: OD at presentation with non-proliferative diabetic retinopathy. Thin arrows: hard exudates; Thick arrow: blot intra-retinal hemorrhage; triangle: microaneurysm
Mentions: Our case was a 46-year-old man, known to have type 2 diabetes mellitus for 10 years and hypertensive for 2 years, on oral hypoglycemic and hypotensive agents, presented to the eye clinic with painless blur of vision in his left eye (OS) of 4 days duration. His best-corrected visual acuity (BCVA) was 6/6 in the right eye (OD) and 6/36 OS with a correction of -0.75 -0.62 ×180 and +0.75 -3.25 ×70, respectively. The intraocular pressure (IOP) was 14 mm Hg in each eye (OU). The anterior segment examination was unremarkable (OU). There was mild relative afferent pupillary defect (RAPD) OS. Posterior segment examination [Figures 1 and 2] showed mild nonproliferative diabetic retinopathy without diabetic macular edema and a normal looking optic disc OD with a small cup-to-disc (CD) ratio (0.1). The OS posterior segment showed a swollen optic disc with telangiectasic vessels and a small CD ratio. There was also diffuse but not cystic, macular edema involving the papillomacular bundle with moderate NPDR. Subfoveal fluid was absent. There were no signs of proliferative disease OU. A CT scan of the brain and orbit was done and did not show any abnormalities. Optical coherent tomography (OCT) was normal OD. However, it revealed significant macular edema with a central macular thickness of 582 μm [Figures 3 and 4] OS. Fundus fluorescein angiography (FFA) OD revealed few microaneurysms, otherwise no evidence of macular or disc leakage. However, FFA OS demonstrated tremendous amount of early optic disc and macular leakage with the presence of microaneurysms, [Figures 5 and 6]. Glycosylated hemoglobin was 12.2%. A formal visual field test was not performed because of a technical reason.

Bottom Line: The right eye fundus showed only mild NPDR.The patient received an intravitreal bevacizumab injection OS followed by focal laser photocoagulation 1 month later.His optic disc swelling and the macular edema subsided rapidly after the injection and his visual acuity improved to 6/6 with disc pallor.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Sultan Qaboos University Hospital, Oman.

ABSTRACT
A 46-year-old diabetic male presented with acute painless visual loss in his left eye (OS). Visual acuity was 6/36 OS with an unremarkable anterior segment examination (OU). Posterior segment showed a swollen left optic disc with large diffuse macular edema and moderate nonproliferative diabetic retinopathy (NPDR). The right eye fundus showed only mild NPDR. Optical coherence tomography and fundus fluorescein angiography were performed which revealed left macular edema and a hyperfluorescent left optic disc. Computerized tomography scan orbit and brain was normal. The patient received an intravitreal bevacizumab injection OS followed by focal laser photocoagulation 1 month later. His optic disc swelling and the macular edema subsided rapidly after the injection and his visual acuity improved to 6/6 with disc pallor.

No MeSH data available.


Related in: MedlinePlus