This is an Optos ultra-widefield fluorescein angiogram of a patient with proliferative diabetic retinopathy. Despite recent panretinal photocoagulation (PRP), there is persistent large disc neovascularization. Extensive capillary nonperfusion is noted superotemporal to the disc and temporarily. Prominent venous beading is also noted inferotemporally. Additional PRP was added.
Learning Points:
Panretinal photocoagulation has been around since the 1960s and still remains the mainstay for treating proliferative disease. Often considered a “one and done,” patients can still develop breakthrough hemorrhages. Intravitreal anti-VEGF injections are often helpful, but some will require vitrectomy.
