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Q. Patient is diabetic and has blurring in the midpoint of the eye. Can you guide me?

Answered by
Dr. Arnab Pal
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jun 21, 2021

Hi doctor,

The patient is a 68-year-old male. He has diabetes for the last 20 years, and he is also having liver cirrhosis issues from two years before. As per age and problems, he can be considered fit as he eats well just like adults and likes to move around and do yoga. But recently, for the past month, he has been facing issues with his right eye. He can see correctly with the side part of the eye, but there is blurring in the midpoint of the eye. To control diabetes, he takes the following medicines: tablet Glycinorm 80 mg two times a day, tablet Remo-Zen 100 mg two times a day, and to control blood pressure, he takes tablet Olmetrack CT 40 once a day as prescribed by a doctor. I need a consultation with an eye specialist doctor.

Lab tests performed:

Blood glucose test.
Creatinine test.
Laser eye test.

#

Hello,

Welcome to icliniq.com.

I have gone through the blood reports and the eye reports (attachment removed to protect the patient's identity).

The blood reports are satisfactory except that PPBS (post-prandial blood sugar) seems a bit high. That needs to be controlled. The eye reports document the reason he sees less with his right eye. He is suffering from age-related degeneration of the central part of the retina called the macula. The clinical term is ARMD (age-related macular degeneration) and, more specifically, choroidal neovascularisation (CNV) with bleeding under the retina. The condition is active CNV.

I am sure the retina specialist would have clearly explained the situation. The subsequent best management would be to inject a highly expensive anti-VEGF (vascular endothelial growth factor) intravitreal injection in the right eye.

There are many options, but injection Accentrix (Ranibizumab) or injection Lucentis solution (Ranibizumab) is the best. Injection Eylea (Aflibercept) and injection Pagenax (Brolucizumab) are also equally good. Injection Razumab (Ranibizumab) and injection Avastin (Bevacizumab) are the less costly injections, but all have shown more or less similar efficacy.

Also, it would be best if you kept in mind more than one injection are needed in almost all cases. Results are good, but you should not expect 100% visual results.

The left eye seems good though a multivitamin capsules like capsule I-Site or capsule Retinox once daily for two months will be helpful to prevent further progression.

I hope I have answered your queries. Do the treatment as soon as possible for the best results.

Regards.


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