Assessment of diabetic retinopathy by FFA to plan the precise treatment.

1. Dr. Anand Sudhalkar, Baroda Diabetic Maculopathy Dr. Anand Sudhalkar

2. Dr. Anand Sudhalkar, Baroda Major cause of blindness FOVEAL INVOLVEMENT Macular Edema Hemorrhage Exudates Ischemia

3. Dr. Anand Sudhalkar, Baroda Macular Edema Retinal Thickening

4. Dr. Anand Sudhalkar, Baroda Macular Exudation Foveal Dot Exudates

5. Dr. Anand Sudhalkar, Baroda Macular Exudation Circinate

6. Dr. Anand Sudhalkar, Baroda Massive exudates

7. Dr. Anand Sudhalkar, Baroda Macular Hemorrhage

8. Dr. Anand Sudhalkar, Baroda Ischemia FAZ Enlargement

9. Dr. Anand Sudhalkar, Baroda Diagnosis Vision testing : Best Corrected VA, . Rule out CATARACT Amsler Chart, Macular fields Indirect Ophthalmoscopy 90 D biomicroscopy FFA

10. Dr. Anand Sudhalkar, Baroda Macular Fields

11. Dr. Anand Sudhalkar, Baroda FLUORESCEIN ANGIOGRAPHY

12. Dr. Anand Sudhalkar, Baroda Microaneurysms

13. Dr. Anand Sudhalkar, Baroda CSME

14. Dr. Anand Sudhalkar, Baroda CSME

15. Dr. Anand Sudhalkar, Baroda Types of Macular Oedema Focal: M.A., High MW lipoproteins, Hard exudates, Circinate patterns. 7

17. Dr. Anand Sudhalkar, Baroda FFA Reveals NVE

18. Dr. Anand Sudhalkar, Baroda Treatment Options Medical Management : Control of Diabetes, HT, Renal failure, anaemia, hypoprotemia, pregnancy, carotid artery diseases Laser Photocoagulation : Patz 1973, British Multicenter Trial 1975, Blankenship 1979, Olk 1986, ETDRS 1985 (ongoing)

19. Dr. Anand Sudhalkar, Baroda ETDRS Multicentric Trial Treated 754, Deferred 1490 After 3 yr. visual loss 12% in treated, 24% in untreated. When centre of macula was involved, treatment effect was more significant at 3 yr.. Visual loss 13% against 33%

20. Dr. Anand Sudhalkar, Baroda Treatment Protocol FFA to identify microaneurysms /capillary leakage & dropouts Focal / grid laser Follow-ups 3 to 6 weekly Repeat FFA & Additional laser if required

21. Dr. Anand Sudhalkar, Baroda Principles of Management : Laser delivery Enlarged & Steady View Slit-Lamp Magnification

22. Dr. Anand Sudhalkar, Baroda Focal Oedema : Focal Laser Identify Culprit M.A. by FFA Identify Centre of Fovea Green Wave, Mainster lens, Short duration, 100um size, minimum treatment Be OnTarget

23. Dr. Anand Sudhalkar, Baroda FFA IN REPEAT TREATMENTS

24. Dr. Anand Sudhalkar, Baroda Grid for Diffuse Edema

25. Dr. Anand Sudhalkar, Baroda Thank You all for patient hearing

26. Dr. Anand Sudhalkar, Baroda Leaking Microaneurysms

27. Dr. Anand Sudhalkar, Baroda PDR

28. Dr. Anand Sudhalkar, Baroda FFA Progress

29. Dr. Anand Sudhalkar, Baroda PDR POST TREATMENT

30. Dr. Anand Sudhalkar, Baroda Progress of NVE

31. Dr. Anand Sudhalkar, Baroda FFA Reveals Venous Beading

32. Dr. Anand Sudhalkar, Baroda FFA in Dense VH

33. Dr. Anand Sudhalkar, Baroda Compare colour picture with FFA

34. Dr. Anand Sudhalkar, Baroda Leaking microaneurysms