Presentation
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46 year old male
• type 2 DM for 12 years • asymptomatic • no previous eye exam • presents for routine care • Visual acuity 20/20
right eye
20/20
left eye
•
Intra-ocular pressure
15
right eye
13
left eye
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Case
Presentation #1
Asymptomatic Patient with Vision Threatening Disease 
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A 46
year old male
with a history of type 2 diabetes for 12 years. The patient is
asymptomatic with visual acuity of 20/20 in both eyes. The patient
underwent an iScan. After dilation the patient’s intraocular
pressures were 15 mm Hg in the right eye and 13 mm Hg in the left (both
normal). Seven-field stereoscopic digital images were acquired and
evaluated according to the standard ETDRS protocol. Right Eye: Mild proliferative diabetic retinopathy, level 61 on the ETDRS Final Severity Scale, with ETDRS clinically significant macular edema (CSME) (double arrow). Any neovascularization (NV) (single arrows) not on the optic disc; or the presence of fibrous proliferation without visible NV characterize ETDRS level 61. Left Eye: Severe nonproliferative diabetic retinopathy, level 53 on the ETDRS Scale, with ETDRS clinically significant macular edema. Very large numbers of microaneurysms and retinal hemorrhages in several areas of the retina; moderate levels of intraretinal microvascular abnormalities (IRMA) in several locations; or venous beading in more than one location characterize ETDRS level 53. |