Journal List > J Korean Ophthalmol Soc > v.58(10) > 1010659

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

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.

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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