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Bilateral Exudative Retinal Detachment in a Diabetic Patient With Severe Peripheral Retinal Ischemia

Monica M. Michelotti, MD1; Nieraj Jain, MD1; Mark W. Johnson, MD1
[+] Author Affiliations
1Department of Ophthalmology and Visual Sciences, W. K. Kellogg Eye Center, University of Michigan, Ann Arbor
JAMA Ophthalmol. 2015;133(1):107-109. doi:10.1001/jamaophthalmol.2014.3491.
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Diabetic macular edema can be resistant to anti–vascular endothelial growth factor (VEGF) therapy, and long-term consequences of VEGF suppression are not well understood.1 Previous studies in central retinal vein occlusion have associated exudative retinal detachment with increased production of VEGF and interleukin 6,2 and localized central serous retinal detachment has been described in diabetic retinopathy.3,4 We observed a patient with chronic diffuse diabetic macular edema who developed extensive bilateral exudative retinal detachment after cessation of long-term anti-VEGF therapy.

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Figure 1.
Preoperative Wide-Field Color Fundus Photographs and Fluorescein Angiograms

Color fundus photographs show partial panretinal photocoagulation scars in the right eye (A), with exudative retinal detachment and preretinal triamcinolone acetonide particles inferiorly in both the right (A) and left (B) eyes. Late-phase fluorescein angiograms reveal extensive peripheral retinal nonperfusion in the right (C) and left (D) eyes.

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Figure 2.
Postoperative Wide-Field Color Fundus Photographs

The retina is attached and macular edema resolved 4 months postoperatively in the right eye (A) and 1 year postoperatively in the left eye (B).

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