How Bad Can Diabetes Eat Your Eyes? Think Before That Next Sweet Bite

Both eye Optos photograph

I saw this patient today and this was not a new patient to my OPD, patient was having BCVA OD : 6/18, OS : HMCF. Patient already underwent PRP (Panretinal photocoagulation) laser for right eye about a month ago.

Patient was having 7.1% HbA1c. After dilatation I saw the patient and and left eye fundus was having Vitreous hemorrhage, Tractional bands along the infero-temporal and supero-temporal arcades.

Right eye was showing 360 degree PRP laser marks and NVE (Neovascularization elsewhere) in inferotemporal quadrant. sclerosed vessels were also present around 1DD to the macula.

We advise both eye OCT scan and it was as below.

OD OCT Macula

OS OCT macula

Diagnosis

Right eye Unstable lasered Proliferative Diabetic Retinopathy (PDR)

Left eye tractional retinal detachment + unstable proliferative diabetic retinopathy

As you can see in right eye there are skip areas of PRP laser temporal to macula so tight PRP is needed as there are NVE.

Left eye requires Pars plana vitrectomy + membrane peeling + Endolaser + Silicon oil infusion.

Right eye is also showing multiple NVE also so there is high chance of large amount of bleeding during surgery so to avoid that we can give Intravitreal Anti VEGF injection prior to the surgery.

Usually Vitrectomy should be perform within 3 to 10 days after the IVI anti VEGF injection. It will reduce the NVE and shrink it down so there will be less amount of bleeding during the surgery.

If you miss the surgery within 10 days Anti VEGF will give traction to the traction band and it will further detaches the retina more and more.

Thank you.