Case Study: Long-Term Retinal Monitoring

An optometrist uploaded this case to Care1.

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A 57-year-old female with diabetes and a history of stroke presented for retinal assessment. She maintains 20/20 visual acuity OU, with a longstanding left-sided visual field defect following her 2017 stroke. Previous assessments documented no diabetic retinal changes, while mild cataracts have been monitored over time. The May 2025 assessment included retinal imaging and ongoing monitoring.

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How should optometrists approach longitudinal retinal monitoring when visual field defects coexist with systemic vascular risk factors?

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Care1 Ophthalmologist's Teleconsult

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The Care1 ophthalmologist reviewed the patient's retinal findings and found no evidence of vision-threatening diabetic retinal changes or macular edema requiring intervention. Continued monitoring and good blood sugar control were encouraged, with annual retinal assessments recommended.

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Care1 AI's Clinical Insight

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Relevant topic: Diabetic Retinopathy

Diabetic retinopathy develops from damage to the retinal microvasculature associated with chronic hyperglycemia. Retinal vascular leakage, capillary closure, and ischemia can contribute to disease progression, while OCT helps identify retinal thickening and fluid associated with diabetic macular edema.

Did You Know?

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Diabetic macular edema can occur at any stage of diabetic retinopathy, meaning macular assessment remains important even when retinal disease appears relatively mild.

Reference: Wong TY, et al. Guidelines on Diabetic Eye Care: The International Council of Ophthalmology Recommendations for Screening, Follow-up, Referral, and Treatment Based on Resource Settings. Ophthalmology. 2018;125(10):1608–1622.