Blurred 2

A 58 year old man presents with blurred vision in his left eye for 1 month.

He was diagnosed with type 2 diabetes mellitus 8 years ago, and is currently on oral Metformin and Glimepiride. His medical history is otherwise unremarkable.

His last ophthalmological evaluation was 2 years ago, at which time mild non-proliferative diabetic retinopathy without clinically significant macular edema was noted.

Select Relevant Investigations
HbA1c

Performed

The HbA1c level is 7.9%
Fluorescein angiography

Performed

Both eyes show multiple severe leakages from neovascularization of the disc and retina; in addition, there is capillary nonperfusion of two quadrants in the right eye and three in the left eye.

Urine Albumin:Creatinine ratio

Performed

12 mg/mmol (normal: < 3.4; microalbuminuria: 3.4 - 34; macroalbuminuria > 34)
Fasting Plasma Glucose

Performed

180 mg/dl (normal: 70-99; prediabetes: 100-126; diabetic: >126)

Select Relevant Management
Photocoagulation L/eye
Photocoagulation R/eye
Aspirin 150 mg/day
ACE Inhibitors