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Lim, Lee, Lee, and Nam: A Case of Rapid Progression to Proliferative Diabetic Retinopathy Associated with Generalized Edema
Case Report

Journal of the Korean Ophthalmological Society 2017; 58(10): 1211-1214.

Published online: 11 October 2017

DOI: https://doi.org/10.3341/jkos.2017.58.10.1211

A Case of Rapid Progression to Proliferative Diabetic Retinopathy Associated with Generalized Edema

Jun Hyun Lim, MD, Seung Uk Lee, MD, Sang Joon Lee, MD, Ki Yup Nam, MD

Department of Ophthalmology, Kosin University College of Medicine, Busan, Korea.

Address reprint requests to Ki Yup Nam, MD. Department of Ophthalmology, Kosin University Gospel Hospital, #262 Gamcheon-ro, Seo-gu, Busan 49267, Korea. Tel: 82-51-990-5217, Fax: 82-51-990-3026, oksman1231@hanmail.net

Received 13 July 2017       Revised 6 September 2017       Accepted 21 September 2017

©2017 The Korean Ophthalmological Society

The Korean Ophthalmological Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

We report a case of rapid progression to proliferative diabetic after generalized edema occurrence in a non proliferative diabetic retinopathy patient.

Case summary

A 48-year-old man visited our hospital with both eyes visual disturbance which occurred 1 week ago. He was diagnosed with moderate non proliferative diabetic retinopathy 5 months ago and there was no significant interval change 3 weeks ago. Date of visit, diffuse macular edema and neovascularization were observed in both eyes. Accompanying visual disturbance, he had generalized edema and 10 kg of weight gain. We thought it was not common diabetic macular edema, we held ophthalmic treatment such as an intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection and requested medical treatment to the department of nephrology. Diagnosed with aggravation of left ventricle heart failure and diabetic nephropathy, he took diuretics and low salt diet for 10 days. After 10 days, his visual acuity improved and macular edema disappeared. Since then, he received intravitreal anti-VEGF injection and panretinal photocoagulation for proliferative diabetic retinopathy treatment. Nevertheless, he underwent pars plana vitrectomy due to vitreous hemorrhage in right eye.

Conclusions

We experienced a case of sudden diffuse macular edema and progression to proliferative diabetic retinopathy associated with generalized edema. We suggest that it is necessary to consider systemic changes in diabetic retinopathy.

Keywords: Macular edema, Non proliferative diabetic retinopathy, Proliferative diabetic retinopathy, Rapid progression, Systemicedema

Figures and Tables

Figure 1

Several ophthalmic examinations at visiting with visual disturbance for 1 week. (A, B) Fundus photography shows diffuse macular edema and retinal hemorrhage. (C, D) Optical coherence tomography shows diffuse macular edema. (E, F) Fluorescein angiography shows fluorescein leakage at the disc in right eye and elsewhere in left eye.

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Figure 2

Optical coherence tomography after diuretics and low salt diet treatment for 10 days. Optical coherence tomography shows absence of diffuse macular edema. OD = oculus dexter; OS = oculus sinister.

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Notes

Conflicts of Interest The authors have no conflicts to disclose.

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