SPONTANEOUS REGRESSION OF DISC NEOVASCULARIZATION IN A TYPE II DIABETIC PATIENT

Title SPONTANEOUS REGRESSION OF DISC NEOVASCULARIZATION IN A TYPE II DIABETIC PATIENT
Author, Co-Author Nadia Zalatimo, Catherine Gelinas
Topic
Year
2009
Day
Friday
Program Number
95542
Room
Crystal H
Affiliation
VA New England Healthcare System, Manchester NH
Abstract BACKGROUND: A 63 year old Type II diabetic patient presented for follow up for severe non-proliferative diabetic retinopathy. On dilated fundus examination, early NVD of <1/3 disc area was noted. One month later, after increasing medical therapy to reduce blood glucose, the NVD had spontaneously regressed.

CASE REPORT(S): A 63 year old Type II DM, white male presented for follow up for severe non-proliferative diabetic retinopathy. The patient’s ocular history included ‘light’ PRP OU over five years prior, with subsequent fill-in PRP OS three years prior, focal laser photocoagulation for CSDME OS four years prior, sub-Tenon Kenalog injection OD for CSDME three years prior. The patient’s medical history included peripheral neuropathy and microalbuminuria.
The patient reported that his blood glucose was ‘fairly’ well-controlled. His HgbA1c was 9.0% the month of his examination. Dilated fundus examination revealed non-high risk PDR OU with a small area of NVE OD and NVD on the nasal edge of disc <1/4 DD OS. There were microaneurysms and dot hemes in 4 quadrants OU, three quadrants of venous beading OU. Peripheral retinal evaluation showed PRP scars OD and dense PRP scars 360 degrees OS.

The patient returned one month later for follow up. He reported no change in vision, but reported that he was taking additional insulin for two weeks. He reported that his blood sugar has been gradually decreasing since starting the additional insulin. Ocular examination was unchanged, with the exception of resolution of NVD OS.
CONCLUSIONS: Spontaneous regression of posterior segment neovascularization, while rare, can occur. This case highlights an unexpected clinical finding that optometrists should be aware of. Patient education on the importance of tight blood sugar control is important for all diabetic patients.
Affiliation of Co-Authors VA New England Healthcare System, Newington CT
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