Proliferative Diabetic Retinopathy with Vitreous Hemorrhage in a 43-Year-Old Man: A Case Report
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Abstract
Proliferative diabetic retinopathy (PDR) is a leading cause of blindness among working-age adults worldwide. This case report presents a 43-year-old male with bilateral PDR complicated by vitreous hemorrhage and cataract, highlighting the importance of early detection and comprehensive management. A 43-year-old male presented with progressive blurring of vision over three months, described as seeing black shadows and floating spots. His right eye had already lost all vision, while the left eye remained severely blurred. The patient had a five-year history of diabetes mellitus managed with insulin. Ophthalmic examination revealed visual acuity of 1/∞ in the right eye and 1/60 in the left eye. Funduscopy was obscured due to media opacity, and B-scan ultrasonography demonstrated diffuse internal echoes in the vitreous cavity consistent with vitreous hemorrhage. Lens opacity was also noted bilaterally. The patient was diagnosed with bilateral proliferative diabetic retinopathy with vitreous hemorrhage and cataract. A combined surgical approach involving phacoemulsification with intraocular lens implantation and pars plana vitrectomy with endolaser and gas/silicone oil tamponade was planned for the left eye. PDR develops as a consequence of chronic hyperglycemia-induced retinal ischemia, leading to neovascularization through increased VEGF. The presence of vitreous hemorrhage in this patient indicates advanced disease requiring surgical intervention. Management of PDR includes panretinal photocoagulation, anti-VEGF therapy, and vitrectomy. This case underscores the vision-threatening nature of PDR and the importance of early detection through regular screening in diabetic patients. Management requires a multidisciplinary approach with meticulous glycemic control and timely surgical intervention when indicated.
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