Case 54, circinate retinopathy
- patient referred from the screening photo below 2010
- What do you see?
- HbA1c 12, age 35, good health…what will happen in 3 years?
- Smokes…what will happen in 5 years?
- What action are you going to take?
circinate retinopathy adjacent to right macula
- the circinate are of exudate is clearly visible (yellow arrow below), but using a green filter (red-free) light, far more retinopathy is visible (blue arrow below).
- the prognosis is poor...diabetic control is poor and the patient smokes. Retinopathy is very unpredictable, but unless these matters are corrected, severe proliferative retinopathy will develop in 3 years, leading to loss of sight. Laser will be needed, and will probably be effective enough to maintain some sight, but not good sight
- If diabetic control improves and the patient stops smoking, the outlook is improved. However, the good control will take at least 3 years to start to have much effect, and so the retinopathy will still progress. Nevertheless, it will then be more likely to respond to laser with a better result (compared to poor control/smoking).
- patients undergoing laser for circinate retinopathy must have their diabetic control and lifestyle examined if visual outcomes are to improve.
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