IOTM: Proliferative Diabetic Retinopathy “Wolf Jaw” with Vitreous Cysts
Image of the Month (IOTM) is a collection of interesting clinical cases with high quality images for all relevant imaging modalities (ex: color fundus, OCT, OCTA, FAF, FA, En Face, Red-free, choroidal vasculography (CVG), anterior imaging) and other clinical results if relevant (ex: visual field plots). Each case is submitted by an eye care professional using one of Topcon’s industry-leading OCT devices.
This is a 51 year old Hispanic male with Type II diabetes for 4 years, systemic hypertension, and hyperlipidemia. Past ocular history unremarkable. Chief complaint was blurred vision and loss of peripheral vision in the right eye for the last 3 months. BCVA 20/80 NIPH OD and 20/150 PH 20/70 OS. Triton Swept Source OCT (SS-OCT) OD (Figure B) defines pre-retinal fibrosis with traction on the peripheral macula sparing the fovea, neovascularization of the disc and subhyaloid cystic spaces. SS-OCT OS (Figure D) defines pre-retinal fibrosis superior to the macula with alteration of the fovea. Based on extensive fibrovascular proliferation in the right eye, management options include conservative observation versus vitrectomy. Given visual acuity and risks associated with vitrectomy, close observation was advised. Treatment in the left eye includes serial anti-VEGF injections and extensive panretinal photocoagulation.
— Jay M. Haynie, OD, FAAO & Himanshu Banda, MD
Diagnosis: Proliferative Diabetic Retinopathy “Wolf Jaw” with Vitreous Cysts
Captured with: Topcon DRI OCT Triton
DRI OCT Triton Images:
A. 45O True Color photo OD shows fibrovascular proliferation with central spared window consistent with “Wolf Jaw” detachment
B. SS-OCT Horizontal B-Scan OD
C. 45O True Color photo OS shows fibrovascular proliferation, disc neovascularization, dot-blot hemorrhage, lipid deposits, and superotemporal tractional detachment sparing central macula
D. SS-OCT Vertical B-Scan OS
The opinions, ideas, views and assumptions expressed are the author’s own and do not necessarily represent the views of Topcon, nor do they constitute advice from Topcon.