DR. SOUMYA SHASHI

DR. REENA KUMARI, DR.DINESH KUMAR BHAGAT

Abstract

A 39-year male with type 1 DM for 10 years with ESRD on twice weekly maintenance hemodialysis presented to the clinic with gross diminution of vision in both eyes. Best corrected visual acuity in both eyes was 1/60. Fundus examination showed (NVD), (NVE), hard exudates at the fovea and exudative RD in both eyes. OCT confirmed presence of large neurosensory detachment at the fovea. Based on the clinical findings, diagnosis of PDR, DME was made and patient was planned for intravitreal (anti-VEGF) i.e., bilateral bevacizumab (1.25mg /0.05ml) injections.Post bevacizumab injection, there was persistence of exudative RD with minimal regression of NVD, NVE. PRP was not feasible because of bilateral subretinal fluid in the peripheral fundus. In view of severe anemia (hemoglobin 5.5 gm%) and deranged renal parameters (urea, 163 mg %; creatinine, 9.8 mg%), he was continued on maintenance hemodialysis. However, renal parameters failed to improve despite multiple sessions of hemodialysis.