J Korean Ophthalmol Soc > Volume 58(10); 2017 > Article
Journal of the Korean Ophthalmological Society 2017;58(10):1211-1214.
DOI: https://doi.org/10.3341/jkos.2017.58.10.1211    Published online October 15, 2017.
A Case of Rapid Progression to Proliferative Diabetic Retinopathy Associated with Generalized Edema.
Jun Hyun Lim, Seung Uk Lee, Sang Joon Lee, Ki Yup Nam
Department of Ophthalmology, Kosin University College of Medicine, Busan, Korea. oksman1231@hanmail.net
전신 부종과 동반되어 급격하게 진행한 증식당뇨망막병증 1예
임준현⋅이승욱⋅이상준⋅남기엽
고신대학교 의과대학 안과학교실
Correspondence:  Ki Yup Nam,
Email: oksman1231@hanmail.net
Received: 13 July 2017   • Revised: 6 September 2017   • Accepted: 21 September 2017
Abstract
PURPOSE
We report a case of rapid progression to proliferative diabetic after generalized edema occurrence in a non proliferative diabetic retinopathy patient. CASE SUMMARY: A 48-year-old man visited our hospital with both eyes visual disturbance which occurred 1 week ago. He was diagnosed with moderate non proliferative diabetic retinopathy 5 months ago and there was no significant interval change 3 weeks ago. Date of visit, diffuse macular edema and neovascularization were observed in both eyes. Accompanying visual disturbance, he had generalized edema and 10 kg of weight gain. We thought it was not common diabetic macular edema, we held ophthalmic treatment such as an intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection and requested medical treatment to the department of nephrology. Diagnosed with aggravation of left ventricle heart failure and diabetic nephropathy, he took diuretics and low salt diet for 10 days. After 10 days, his visual acuity improved and macular edema disappeared. Since then, he received intravitreal anti-VEGF injection and panretinal photocoagulation for proliferative diabetic retinopathy treatment. Nevertheless, he underwent pars plana vitrectomy due to vitreous hemorrhage in right eye. CONCLUSIONS: We experienced a case of sudden diffuse macular edema and progression to proliferative diabetic retinopathy associated with generalized edema. We suggest that it is necessary to consider systemic changes in diabetic retinopathy.
Key Words: Macular edema;Non proliferative diabetic retinopathy;Proliferative diabetic retinopathy;Rapid progression;Systemicedema


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