Complex Treatment of Proliferative Diabetic Retinopathy with Focal Photocoagulation of Diabetic Macular Edema in Oldest-Old Female: A Clinicopathologic Case Report
Abstract:
Diabetic macular oedema (DME) is the most frequent cause of visual loss among diabetic patients. The accumulation of comorbidities makes the ageing diabetic more fragile, especially in oldest-old adults, and is linked to increased hospitalisation and death rates. This case report analyses the complex treatment of Proliferative Diabetic Retinopathy with focal Photocoagulation of DME in an oldest-old woman who initially arrived with numerous diabetic comorbidities. An 82-year-old woman visited ophthalmology OPD twelve years before to perform cataract surgery. During that time, the patient did not have diabetic retinopathy at the baseline. One year before, due to irregular medication, she developed DME and best-corrected visual acuity (BCVA) was 6/36 in the right eye and prescribed to be under insulin therapy. Optical coherence tomography confirmed the presence of macular oedema and showed areas of retinal capillary non-perfusion and retinal leakage from numerous microaneurysms in the macular area. Following that, unilateral focal photocoagulation was planned. Despite grid laser, the macular oedema persisted and after two sessions of laser therapy, the macular oedema was reduced and the patient was satisfied with her vision. There is a need for further research on focal photocoagulation of DME among oldest-old adults.
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