early retinopathy and morbid obesity
- female 1960, diabetic 2001, morbid obesity
- 2012 Jan HbA1c 13%
- 2012 July HbA1c 8.5% and dropping;
- left laser, more macular central..next?
2012 more macular oedema (OCT below)
2011 early retinopathy
Vision remains good but the oedema has increased. The leakage is too central for effective laser. See graph: enlarge
- The oedema has increased despite the great improvement in diabetic control (HbA1c as above). Good control may help in the long term, but may make the retinopathy worse in the short term.
- At this stage the prognosis in uncertain...it may get a lot worse.
- To prevent such problems, the NHS needs to porvide more effective treatment
- prevention obesity (exercise/healthy diet)
- treatment for the obesity, support in the early stages (advice, nursing support)
- for morbid obesity bariatric surgery fobefore diabetic complications
- Show patients their retinopathy photo..a good motivational step.
- Avastin would be helpful here, especially if the vision becomes reduces.
home / help/abbreviations; / Case 1a / Case 23 / Case 25 / Case 26 / Case 27 / Case 28 / Case 29 / Case 30 Case 31 / Case 32 / Case 33 / Case 34 / Case 35 / Case 36 maculopathy / Case 37 maculopathy / Case 38 early mac / Case 39 mild preproliferative / Case 40 exudates before/after laser / Case 41 prolif/screening / Case 42 circinate / Case 43 prolif / Case 44 early maculopathy / Case 45 prolif / Case 46 acute mac oedema 2mb / Case 47 enlarging laser burns / Case 48 nearly burnt out / Case 49 macular oedema / Case 50 severe retinopathy Case 51 circinate / Case 52 severe non-prolif / Case 53 maculopathy / Case 54 circinate / Case 55 HbA1c improves / Case 56 mac oed / Case 57 mac oed / Case 58 proliferative / Case 59 haemorrhages / MORE CASES