This 50YO female with a history of type 2 diabetes was referred for new floaters. Several years earlier, we began panretinal photocoagulation (PRP) for proliferative diabetic retinopathy (PDR), but she had been lost to follow-up.
Optos color RG imaging shows dense asteroid hyalosis with a hazy inferior preretinal hemorrhage. Fluorescein angiography (FA) shows significant retinal ischemia, scattered retinal neovascularization, and partial PRP scarring.
Examining the fundus with dense asteroid, as in this diabetic patient, can be extremely challenging. FA and OCT are great modalities because they can visualize the retina when the clinical exam can’t. Optos FA was critical in confirming proliferative retinopathy with peripheral ischemia in our patient.
We were fortunately able to complete the PRP despite the vitreous opacities.
