Transcript 視網模病變
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 力不良 Floater, metamrophopsia, photopsia 視 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
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
Thank you