Eye Atlas—Proliferative Diabetic Retinopathy
This is the retina of a 45-year-old female who complained of sudden, painless, loss of vision in her right eye. She reported that upon awakening she could could not see anything at all out of that eye and it looked red when she looked at light. The patient had a ten year history of diabetes type 2 with poor control of her blood sugar.
Diabetes causes the blood vessels that supply the retina to die. As a result the eye is deprived of oxygen. In response, the eye grows new blood vessels. However, these new blood vessels, or neovascularization, are fragile and leaky.
This patient developed neovascularization as a result of a poorly oxygenated eye. These blood vessels leaked causing the large hemorrhages seen in the photograph.
The eye is filled with a clear jelly called the vitreous. Some of this blood has leaked into the vitreous, like the blood at the bottom of this photograph. Some of the blood has collected behind the vitreous. The blood at the top of the photography is mostly behind the vitreous. If you look closely at the photograph you can see that the blood is at two different levels. The hemorrhage at the bottom should look closer than the hemorrhage at the top.
This patient was referred to a retinal specialist who will perform a procedure known as a vitrectomy. A vitrectomy involves the removal of the vitreous. Hopefully, this will restore this patient’s vision.
However, had the patient been seen early in the process, a less invasive laser procedure called pan-retinal photocoagulation could have performed which would have caused the neovascularization to regress. Regression of the neovascularization could have prevented this outcome from occurring.