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1. How do I read FFA in a diabetic patient? Dr. AnandSudhalkar 11April 2010 At Dr. T. V. Patel eye institute, Salatwada, Baroda. www.sudhalkareyehospital.com 1

2. Why FFA? www.sudhalkareyehospital.com 2

4. Study the integrity of BRB

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7. Predict the Prognosis.

8. Plan Follow-ups and Documentationwww.sudhalkareyehospital.com 4

9. Prerquisites Detailed History : Systemic and Ocular Complete Ophthalmic workup with BCVA Thorough Indirect Ophthalmoscopy Colour vision, Amsler test, OCT FFA with a purpose www.sudhalkareyehospital.com 5

11. Recent Pseudophakia LE 1 monthDimness of vision LE. 1 month post IOL

12. RE CAT -3.0 90*=6/36

13. LE IOL -2.0 90*=6/60

14. Fundus: BDR

15. Urea 60 S. Creat. 3.5www.sudhalkareyehospital.com 6

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17. LE POST IOL Surgery www.sudhalkareyehospital.com 8

18. www.sudhalkareyehospital.com 9 Case 2. M/62, (7491 Mohan Joshi), NIDDM 7 years, Dimness 3 months RE +1.0=6/36, LE +1.0=6/36 Imm. Cat BE, Fundus: Severe NPDR RE, PDR LE Hb A1C 7.5, S. Creat. 0.74

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21. www.sudhalkareyehospital.com FFA further sequence 12 PDR

22. Case 3. Chandwani 42758 M/50yrs, NIDDM 5 yrs. Dimness one year in BE, sudden loss RE 15 days RE: FC inferiorly LE: 6/36 Phakic BE Fundus: PDR BE, VH RE Hb A1C: 11.2 Sr. Creat 1.4, Urine Alb 4+ www.sudhalkareyehospital.com 13

23. PDR RE www.sudhalkareyehospital.com 14

24. PDR LE + FAZ enlargement www.sudhalkareyehospital.com 15 Capillary dropouts, Enlarged FAZ

25. Case 4. M/57 yrs, NIDDM 7 yrs Sudden Loss LE 2 days RE: -2.0=6/60, Cataract++ LE: 6/60 uncorrected VH++ RE Advanced Cataract, LE PDR+VH Hb A1c 8.5 www.sudhalkareyehospital.com 16 Janak Desai

26. www.sudhalkareyehospital.com 17 Cataract RE FFA for “invisible” NVE

27. www.sudhalkareyehospital.com 18 NVD,High risk PDR LE

28. Case 5KantabenChauhan 43245 F/55yrs. NIDDM 6 yrs (28-Apr-04) Routine test for glasses. RE +1.0= 6/9, LE +1.0= 6/9 IOP: RE 17, LE 16 Next visit 9-Oct-07, RE 6/9, LE 6/9, IOP RE: 23, LE 18, Cupping RE> LE, disc hemorrhage+ www.sudhalkareyehospital.com 19

29. Case 8 cont. www.sudhalkareyehospital.com 20

30. Case 8 cont 27-Nov 07 www.sudhalkareyehospital.com 21

31. Case 5 Cont. Year later RE www.sudhalkareyehospital.com 22 RE: +1.5=6/12

32. LE CSME Focal Leak, www.sudhalkareyehospital.com Focal laser 23 LE: +1.0=6/12

33. Case 6.Vithalgaikwad 7463 M/76yrs. NIDDM 6 yrs Dimness 3months PCIOL BE RE FC PCO++ LE +1.0=6/36 Sr. Creat. 1.09, HbA1C 6.5 www.sudhalkareyehospital.com 24

34. RE www.sudhalkareyehospital.com 25 Focal Laser before Yag

35. www.sudhalkareyehospital.com FFA to locate Leaking Microaneurysms in PDR+CSME 26

36. FFA before starting PRP www.sudhalkareyehospital.com 27 FFA reveals capillary dropouts in severe PDR

37. FFA before repeat treatments www.sudhalkareyehospital.com 28

38. Case 7.Bedekar M/73 IDDM 36 yrs, BE IOL RE 6/12 LE 6/18 LE Macular Hem Hb A1c 9.60 www.sudhalkareyehospital.com 29

39. Non leaking M.A. www.sudhalkareyehospital.com 30 Bedekar 3068

40. Case 8.Bhadresh Patel 7381 M/60yrs NIDDM 7 yrs Dimness LE 2months, RE 6/6, LE 6/12 Past H/O retinopexy BE 7 yrs www.sudhalkareyehospital.com 31

41. FFA to highlights diabetic changes under ERM www.sudhalkareyehospital.com 32

42. Case 9 F/71 Purnima Desai 2430 NIDDM 21 yrs. Routine check up BE IOL RE: -1.0-1.0 90*=6/9 LE: - +1.0 180*=6/9 Fundus: Drusens BE www.sudhalkareyehospital.com 33

43. Drusens with M.A. www.sudhalkareyehospital.com 34

44. www.sudhalkareyehospital.com Thank You all for patient hearing 35