Case 51 Circinate retinopathy
- 1937 dob, Female patient
- 2002 type 2 diabetes
- 2009 right eye focal laser, for circinate retinopathy
- 2010 March circinate
still present, second laser,
(photos and scan here, on the right)
- 2010 September circinate has changed a little, but there is more oedema (blue arrows).
- The increase in oedema is shown with the graph: green line September, blue line March.
- sight throughout good (6/75 right/left)
In March 2010 patient was tired and very obese. The gliclazide was stopped and replaced with Sitagliptin. At the next visit patient felt better and had lost weight.
Her diabetes was controlled (HbA1c ~7.3% throughout). In March 2010 th blood pressure was a little high so medication was increased (150/70) ARB, perindpril. LDL of 2.2 mmol/l, a little high.
I am still uncertain as to why the retinopathy has increased (good HbA1c for 8 years). All I could suggest was more laser and lower blood pressure. Our Avastin funding is erratic but in any respect patient has declined Avastin…she has good sight at this stage.
Medication at this stage:
- Metformin 1 g bd
- Sitagliptin 100 mg od
- Atenolol 50 mg od
- Amlodipine MR 10 mg od
- Perindopril 2 mg od
- Simvastatin (increasing from 20 to 40 mg in September)
- Aspirin 75 mg od