Adam,Rouilly AR403 - Page 16

Condion 6
This view is of the central fundus with the opc disc
The main clinical features are:
• Focal areas of pigmentaon consistent with
focal laser photocoagulaon
• Mulple hard exudates are seen within the
macular area
• Some in a circinate paern with central
Microaneurysms
This diagnosis is consistent with:
DIABETIC MACULOPATHY: ONGOING WITH PREVIOUS FOCAL LASER PHOTOCOAGULATION
Comment:
Visual acuity will almost certainly be ≤ 6/12. Microaneurysms leak plasma which precipitates
in a lipid-rich protein deposit which is hard exudate. The circinate nature of some hard
exudates with central Microaneurysms clearly suggests this. The central Microaneurysms
within a clump or circinate of exudates are laser photocoagulated to obliterate and seal the
Microaneurysms to reduce plasma leakage.
Condion 5
This view is of the opc disc
The main clinical features are:
• New Vessels formaon on the disc (NVD)
• Myopic Crescent over the temporal edge of
the opc disc
• Peripheral renal pigment layer prominence
This diagnosis is consistent with:
PROLIFERATIVE RETINOPATHY WITH NEW VESSELS ON THE DISC (NVD)
Comment:
New Vessels on the disc are oen dicult to see and the rst sign of Proliferave Diabec
Renopathy. Myopic Crescent over the temporal edge of the opc disc is subtle with
peripheral renal pigment layer prominence (oen seen in Myopia). This should not be
confused with Renis pigmentosa. The New Vessels will grow further into the vitreous and
are fragile and can lead to haemorrhage.
16
Condions and Diseases of the Rena (Connued)