reading ffa in diabetics 11 april 2010 by dr. anand sudhalkar vadodara

How do I read FFA in a diabetic

patient?

Dr. Anand Sudhalkar

11April 2010At Dr. T. V. Patel eye institute, Salatwada, Baroda.

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Why FFA?

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What does it offer?

Dynamic display of chorioretinal circulation

Study the integrity of BRB

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Expectations from FFA

Diagnostic:

1. To confirm the clinical findings

2. To know if the retinopathy is significant or

Vision threatening?

Precision in planning the treatment

Predict the Prognosis.

Plan Follow-ups and Documentation

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Prerquisites

Detailed History : Systemic and Ocular

Complete Ophthalmic workup with BCVA

Thorough Indirect Ophthalmoscopy

Colour vision, Amsler test, OCT

FFA with a purpose

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Case 1

Male/56 (41686 Satish Patel) NIDDM 10 yrs

Recent Pseudophakia LE 1 month

Dimness of vision LE. 1 month post IOL

RE CAT -3.0 90*=6/36

LE IOL -2.0 90*=6/60

Fundus: BDR

Urea 60 S. Creat. 3.5

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LE POST IOL Surgery

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Case 2.

M/62, (7491Mohan Joshi), NIDDM 7 years,

Dimness 3 months

RE +1.0=6/36, LE +1.0=6/36

Imm. Cat BE,

Fundus: Severe NPDR RE, PDR LE

Hb A1C 7.5, S. Creat. 0.74

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FFA further sequence

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PDR

Case 3. Chandwani 42758

M/50yrs, NIDDM 5 yrs.

Dimness one year in BE, sudden loss RE 15 days

RE: FC inferiorly

LE: 6/36

Phakic BE

Fundus: PDR BE, VH RE

Hb A1C: 11.2 Sr. Creat 1.4, Urine Alb 4+

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PDR RE

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PDR LE + FAZ enlargement

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Capillary dropouts, Enlarged FAZ

Case 4.

M/57 yrs, NIDDM 7 yrs

Sudden Loss LE 2 days

RE: -2.0=6/60, Cataract++

LE: 6/60 uncorrected VH++

RE Advanced Cataract, LE PDR+VH

Hb A1c 8.5

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Janak Desai

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Cataract RE

FFA for “invisible” NVE

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NVD,High risk PDRLE

Case 5

Kantaben Chauhan 43245

F/55yrs. NIDDM 6 yrs (28-Apr-04)

Routine test for glasses.

RE +1.0= 6/9, LE +1.0= 6/9

IOP: RE 17, LE 16

Next visit 9-Oct-07, RE 6/9, LE 6/9,

IOP RE: 23, LE 18,

Cupping RE> LE, disc hemorrhage+

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Case 8 cont.

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Case 8 cont 27-Nov 07

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Case 5 Cont. Year later RE

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RE: +1.5=6/12

LE

CSME Focal Leak,

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Focal laser

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LE: +1.0=6/12

Case 6.Vithal gaikwad 7463

M/76yrs. NIDDM 6 yrs

Dimness 3months PCIOL BE

RE FC PCO++

LE +1.0=6/36

Sr. Creat. 1.09, HbA1C 6.5

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RE

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Focal Laser before Yag

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FFA to locate Leaking Microaneurysms in

PDR+CSME

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FFA before starting PRP

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FFA reveals capillary dropouts in severe PDR

FFA before repeat treatments

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Case 7. Bedekar

M/73 IDDM 36 yrs,

BE IOL

RE 6/12

LE 6/18

LE Macular Hem

Hb A1c 9.60

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Non leaking M.A.

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Bedekar 3068

Case 8.Bhadresh Patel 7381

M/60yrs NIDDM 7 yrs

Dimness LE 2months, RE 6/6, LE 6/12

Past H/O retinopexy BE 7 yrs

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FFA to highlights diabetic changes

under ERM

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Case 9

F/71 Purnima Desai 2430 NIDDM 21 yrs.

Routine check up

BE IOL RE: -1.0-1.0 90*=6/9

LE: - +1.0 180*=6/9

Fundus: Drusens BE

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Drusens with M.A.

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