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