Patient description
A 60-year-old Black male presents for evaluation of blurry vision bilaterally at distance and near. He is a Type 2 Diabetic of greater than 10 years duration with a blood sugar reading that morning of 273. He does not know his HbA1C. He has a history of 3 laser treatments in his right eye for diabetic macular edema. BCVA measured 20/50 OD and 20/20 OS.Clinical Findings
In this patient, fundus photography revealed four quadrants of retinal hemorrhages, scattered cotton wool spots and exudation bilaterally. (1) In addition, there was evidence of anomalous vasculature in the left eye (blue arrows). SD-OCT confirmed the presence of macular edema OU with coinciding irregularity and enlargement of the foveal avascular zones on OCTA. (2) Widefield 12x12 OCT Angiography confirmed two distinct neovascular fronds indicating the presence of neovascularization suggestive of proliferative disease OS. (3) In addition, there was evidence of widespread capillary nonperfusion bilaterally as well. Retinal thickness slabs highlighted the extensive edema throughout the posterior pole. (4) Due to the widefield capabilities of the Solix retina protocol, the full extent of the neovascular fronds could be captured.
Conclusion
With a single scan, the Optovue Solix by Visionix generates all OCT and OCT-A images and data for comprehensive retinal analysis.
Dr. Julie Rodman is the Chief of the Broward Eye Care Institute in Fort Lauderdale, FL and a Professor of Optometry at Nova Southeastern University. Her research interests include OCT/OCT-A and Vitreoretinal Disease. Dr. Rodman has authored over thirty publications with an emphasis on retinal disease. She recently published “Optical Coherence Tomography Atlas: A Case Study Approach,” the first reference book on this topic written by an optometrist. Dr. Rodman is a member of the AOA, AAO, FOA, and ORS. She has been the recipient of numerous teaching awards and was recognized as a Primary Care Optometry News “Top 300” Optometrists and “Newsweek Best Optometrists of 2021.”