糖尿病視網膜病變
糖尿病視網膜病變
視力模糊, 眼前黑影, 畏光, 流淚What’s your suggestion ?
糖尿病眼病變 Keratopathy 角膜 Cataract白內障 Glaucoma 青光眼 Retinopathy視網膜
Symptpms Painless white eye/ painful red eye 紅眼 Decrease of central vision / total visual loss 視力不良 Floater, metamrophopsia, photopsia 飛蚊 閃光
Examinations檢查 Visual acuity 視力 Biomicroscope ( slit lamp) Fundus direct ophthalmoloscope indirect ophthalmoloscope Ultrasonography Fluorescein angiography ( FAG )
螢光眼底血管攝影檢查
Diabetic retinopathy糖尿病視網膜病變 Background diabetic retinopathy ( BDR ) Preproliferative diabetic retinopathy ( PPDR ) Proliferative diabetic retinopathy ( PDR ) Clinical significant macular edema ( CSME )
Vessel occlusion and Microaneurysm
Hard exudate ---
Background diabetic retinopathy (BDR) Microaneurysm Hemorrhages Hard exudate Retinal edema
Preproliferative diabetic retinopathy ( PPDR ) Vascular change ( beading, looping, sausage-like ) Cotton-wool spots Intraretinal microvascular abnormalities
4-2-1 rule for panretinal photocoagulation Microaneurysm or hemorrhage (4 quadrants) Venous beading (2 quadrants) Intraretinal microvascular abnormalities (1 quadrant) ETDRS ophthalmomogy. 1991
PDR
Proliferative diabetic retinopathy ( PDR ) Retinal neovasculization Vitreous hemorrhage Tractional retinal detachment
Clinical significant macular edema ( CSME )
Laser photocoagulation 視網膜光凝固鐳射治療 1. Clinical significant macular edema ( CSME ) Focal retinal photocoagulation ( FRP ) 2. Neovascularization or severe PPDR Panretinal photocoagulation ( PRP ) ophthalmomogy. 1995
雷射
視網膜光凝固鐳射治療
Surgery手術 Intravitreal injection of steroid For clinical significant macular edema ( CSME ) ophthalmomogy. 2003 Pars plana vitrectomy for vitreous hemorrhage and tractional retinal detachment ophthalmomogy. 1998
Intravitreal injection of steroid眼內注射藥物 For clinical significant macular edema ( CSME ) Elevated intraocular pressure Cataract
pars plana vitrectomy手術
Follow up schedule追蹤
Message to take back記住 Always follow up regularly定期追蹤 Early diagnosis and early treatment早期診斷早期治療
Their sight in your hands
Thank you