- Male, dob 1955
- Dm 2005 HbA1c 10%
- 2005-2012 HbA1c 7%
- Baker, mildly obese
- laser 2007, 14 sessions,
- 2012 nearly stable now, no haemorrhages..laser burns and CME
2012 arrow points to a foveal cyst (a type of macular oedema 'CME')
there are only a few haemorrhages so the retinopathy is nearly stable
- the patient controlled his diabetes immediately it was diagnosed. Despite this the retinopathy progressed, and he developed new vessels (~2009) and needed lots of laser.
- His retinopathy developed in 2007, 2 years after he was diagnosed with diabetes (2005). But we know it takes >9 years to develop retinopathy, so he must have been diabetic many years and not known about it.
- If we are to prevent such cases, we must screen people for diabetes (e.g. an HbA1c every 3y).
- The retinopathy developed despite the good control..the retinopathy has a 'memory' of the high glucose levels. We generally say it takes 3 years of good control before the retinopathy comes under control and stops progressing, but this patient illustrates it may take a lot longer.
- The retinopathy was detected early by the excellent screening program.
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