Diabeticretinopathyafternoon case 1, Good Hope Hosp, 2005 Case 1 What is going on here? Discuss the possible diabetic history etc…age/type/control/duration

Diabeticretinopathyafternoon case 1, Good Hope Hosp, 2005

Case 1

What is going on here?

Discuss the possible diabetic history etc…age/type/control/duration


Case 1

(Need to compare to case 2 later)


1995 ..background retinopathy & laser burns, for maculopathy…point out features

Dob 14.10.66, dm age 9, type 1 diabetes

What is going to happen next? What would you like to know to be able to predict what is going to happen next?


Developed new vessels, requiring lots of laser, not really visible on photos

…but see para-foveal haem..sign of proliferation

..very important for interpreting screening photos


1998 …what is happening here?Does the patient have new vessels?What has happened in between?Is the diabetes controlled? Is the retinopathy controlled?What will happen next?


1998 …what is happening here?Does the patient have new vessels?What has happened in between?Is the diabetes controlled? Is the retinopathy controlled?What will happen next?

Blot haems, maculopathyProbably/will do soon

laser for PRPNo! No!

More new vessels etc


There are new vessels…what is the treatment?

Grid/focal for maculopathy, and PRP for NVE


95-99 lots of laser for new vessels


1999 • Still has retinal haemorrhages, no new

vessels remaining• HbA1c 5.5%, insulatard & actrapid• Still smoking 10/cigarettes/day, unable

to stop• 3 pints beer a night (6 units)• started an ACE inhibitor at request of

ophthalmologist (3rd request)


2000• Really excellent diabetic control continues• Reasonable BP, smokes• Cuts down alcohol to 3 units/night


2003• What has happened

to retinal haemorrhages?

..much less, therefore prognosis good.

Documents

Diabeticretinopathyafternoon case 1, Good Hope Hosp, 2005 Case 1 What is going on here? Discuss the possible diabetic history etc…age/type/control/duration