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糖尿病視網膜病變. 視力模糊, 眼前黑影, 畏光, 流淚 What ’ s your suggestion ?

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Presentation on theme: "糖尿病視網膜病變. 視力模糊, 眼前黑影, 畏光, 流淚 What ’ s your suggestion ?"— Presentation transcript:

1 糖尿病視網膜病變

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3 視力模糊, 眼前黑影, 畏光, 流淚 What ’ s your suggestion ?

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5 糖尿病眼病變 Keratopathy 角膜 Cataract 白內障 Glaucoma 青光眼 Retinopathy 視網膜

6 Symptpms Painless white eye/ painful red eye 紅眼 Decrease of central vision / total visual loss 視 力不良 Floater, metamrophopsia, photopsia 飛蚊 閃光

7 Examinations 檢查 Visual acuity 視力 Biomicroscope ( slit lamp) Fundus direct ophthalmoloscope indirect ophthalmoloscope Ultrasonography Fluorescein angiography ( FAG )

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11 螢光眼底血管攝影檢查

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13 Diabetic retinopathy 糖尿病視 網膜病變 Background diabetic retinopathy ( BDR ) Preproliferative diabetic retinopathy ( PPDR ) Proliferative diabetic retinopathy ( PDR ) Clinical significant macular edema ( CSME )

14 Vessel occlusion and Microaneurysm

15 Hard exudate Hard exudate ---

16 Background diabetic retinopathy (BDR) Microaneurysm Hemorrhages Hard exudate Retinal edema

17 Preproliferative diabetic retinopathy ( PPDR ) Vascular change ( beading, looping, sausage-like ) Cotton-wool spots Intraretinal microvascular abnormalities

18 4-2-1 rule for panretinal photocoagulation Microaneurysm or hemorrhage (4 quadrants) Venous beading (2 quadrants) Intraretinal microvascular abnormalities (1 quadrant) ETDRS ophthalmomogy. 1991

19 PDR PDR

20 Proliferative diabetic retinopathy ( PDR ) Retinal neovasculization Vitreous hemorrhage Tractional retinal detachment

21 Clinical significant macular edema ( CSME )

22 視網膜光凝固鐳射治療 Laser photocoagulation 視網膜光凝固鐳射治療 1. Clinical significant macular edema ( CSME )  Focal retinal photocoagulation ( FRP ) 2. Neovascularization or severe PPDR  Panretinal photocoagulation ( PRP ) ophthalmomogy. 1995

23 雷射

24 視網膜光凝固鐳射治療

25 Surgery 手術  Intravitreal injection of steroid For clinical significant macular edema ( CSME ) ophthalmomogy  Pars plana vitrectomy for vitreous hemorrhage and tractional retinal detachment ophthalmomogy. 1998

26 Intravitreal injection of steroid 眼內注射藥物 For clinical significant macular edema ( CSME ) Elevated intraocular pressure Cataract

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28 Follow up schedule 追蹤

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30 Message to take back 記住 Always follow up regularly 定期追蹤 Early diagnosis and early treatment 早期診斷早期治療

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32 Thank you


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