A 60 year old type 2 diabetic with HbA1c of 10.3% presents to the OPD for glycemic control. We perform a routine target organ evaluation. On Dilated fundus examination we find the following:
Q1. What are the findings in this fundus examination ?
We can see the following:
1. Hard exudates close to Macula
Q2. What would the severity classification of Diabetic retinopathy in this case?
This would be classified as Moderate Nonproliferative Diabetic retinopathy with clinically significant macular edema
This is because the Hard exudates are close to the macula.
Q3. What would you do next for this patient ?
I would refer this patient to a retina specialist since clinically significant macular edema is considered as sight threatening.
Q4. What would be the management for this patient ?
1. Intensive glycemic and blood pressure control (with avoidance of Pioglitazone)
2. Intravitreal anti-VEGF would the treatment of choice for this patient.