ND:YAG laser for preretinal hemorrhage in diabetic retinopathy

Abstract

Purpose: To present fundus images of a case with severe preretinal hemorrhage in diabetic retinopathy that was treated with posterior hyaloidotomy with an Nd:YAG laser.

Observations: A 35-year-old diabetic patient presented with sudden painless loss of vision due to severe preretinal hemorrhage over the macular area and high risk proliferative diabetic retinopathy. Her visual acuity was counting fingers. Posterior hyaloid face was treated with Nd:YAG laser (posterior hyaloidotomy). Panretinal laser photocoagulation was first performed to control the proliferative diabetic retinopathy. Blood drained inferiorly into the vitreous cavity with clearance of the premacular area.

Conclusions and importance: Prompt treatment with Panretinal laser photocoagulation followed by posterior hyaloidotomy with the YAG laser is a viable option in order to avoid further proliferative diabetic retinopathy complications and vision loss. The current image clearly depicts treatment efficacy.

Keywords: Diabetic retinopathy; Panretinal photocoagulation; Preretinal hemorrhage; YAG laser.

Fig. 1

A: color fundus photograph of the patient's right eye upon presentation. A severe preretinal hemorrhage covering the macula is the cause of vision loss. Intraretinal hemorrhages due to diabetic retinopathy are also visible. B: Color fundus photograph of the patient's right eye immediately after the perforation of the posterior hyaloid face with the Nd:YAG laser (posterior hyaloidotomy), (white arrows). Panretinal laser photocoagulation (PRP) was first performed to control the proliferative diabetic retinopathy (black arrows). C: Color fundus photograph of the patient's right eye after posterior hyaloidotomy demonstrating blood drainage inferiorly into the vitreous cavity (white arrows), and clearance of the premacular area. (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article.)