Case background

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

Slide A

Slide B

Slide C

Slide D

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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.