Images in Clinical Medicine

Proliferative Diabetic Retinopathy

Pukhraj Rishi, M.S., and Pramod S. Bhende, M.S.

N Engl J Med 2009; 360:912February 26, 2009

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Article

A 56-year-old man with diabetes presented with a several-month history of decreased vision in the left eye. There was no history of trauma, flashes of light, or floaters. Visual acuity was 20/20 in the right eye and 20/200 in the left. Examination of the left eye revealed extensive retinal neovascularization (Panel A, arrowheads) superior to the optic disk (asterisk), as well as underlying retinal detachment (arrows). A monoclonal antibody against vascular endothelial growth factor was injected into the eye to reduce vascular proliferation before anticipated surgery. One week after a single intravitreal injection and 3 days before vitreous surgery, dramatic regression of vascular proliferation was seen (Panel B, arrowheads). Three months later, the retina remained attached, there was silicone oil in situ, and visual acuity had improved to 20/160.

Pukhraj Rishi, M.S.
Pramod S. Bhende, M.S.
Sankara Nethralaya, Chennai 600006, India