This 33YO female with type 2 diabetes was in the process of being treated with intravitreal Eylea, macular laser, and panretinal photocoagulation (PRP) for bilateral center-involved diabetic macular edema and proliferative diabetic retinopathy (PDR). She presented on 6/8/23 with recent vision loss OD and was overdue for this visit because of numerous medical issues. Vision had decreased to 20/400 OD.
Color imaging shows dark red preretinal blood obscuring the optic nerve and central macula. After several monthly Eylea injections and completion of the PRP, the preretinal blood became yellow and devitalized on 1/11/24, before finally completely absorbing, as noted at last examination on 4/25/24, with stable 20/400 vision. Despite full PRP, diffuse variably fibrosed neovascularization persists, along with venous beading. OCT scanning revealed no edema with central atrophy (not shown).
Our patient was initially in no rush for vitrectomy surgery, as vision in her fellow eye was 20/50. Conservative management with intravitreal injections and PRP was thankfully successful. This approach was also found to be safe and effective by Brar et al in a retrospective series of 22 eyes with foveal preretinal blood from PDR (Ind J Ophthalmol 2024;72:687-691).
