Central Carolina Surgical Eye Associates, P.A.

Case five: Proliferative Diabetic Retinopathy

neovascularization of the disk proliferative diabetic retinopathy new blood vessels vitreous hemorrhage proliferative diabetic retinopathy
Color fundus photo of the right eye reveals neovascularization of the optic disc (NVD) with neovascularization elsewhere (NVE). Color fundus photo of the left eye reveals NVD, NVE, surface retinal hemorrhage and vitreous hemorrhage.
right eye NVD NVE left eye traction retinal detachment proliferative diabetic retinopathy
Red free photo of the right eye reveals better visualization of the NVD and NVE. Red free Photo of the left eye reveals traction retinal detachment (TRD) and vitreous hemorrhage.
fluorescein angiogram diabetic eye disease leakage of retinal blood vessels
Early fluorescein angiogram of the left eye reveals early filling of the retinal arteries and neovascularization of the optic disk. Black areas represent vitreous hemorrhage Early venous phase angiogram of the left eye reveals increased filling of NVD and early leakage from retinal vessels. This NVD is lifting the retina, causing TRD.
late leakage of abnormal retinal vessels venous beading capillary damage proliferative diabetic retinopathy
Late phase angiogram reveals diffuse leakage of fluorescein dye from the abnormal retinal vessels.
(Note white areas).
This digitally enhanced photo reveals marked "venous beading"(VB), and intraretinal microvascular anomalies(IRMA), with severe capillary damage.


This case of a 37 year old Caucasian male diabetic of 24 years illustrates the classic signs of proliferative diabetic retinopathy (PDR). This stage often occurs as a result of poorly controlled blood glucose over many years. Since this was found at his first eye exam, he was not aware of any problem with his vision. His vision was 20/20 RE and 20/40 LE. This stage of retinopathy was proven in the Diabetic Retinopathy Study to place the patient at high risk for severe vision loss. Therefore, prompt pan retinal photocoagulation was performed after counseling with the patient and his family. He also required pars plana vitrectomy (PPV) surgery in his left eye. At this time he is doing well. He was fortunate to receive prompt treatment and his vision has been preserved.

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